使用 Tc-99m DMSA 进行儿童肾皮质成像:机构审查

IF 0.6 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Septi Hardina, T. Nugrahadi, H. Budiawan, A. Kartamihardja
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引用次数: 0

摘要

摘要 背景 尿路感染(UTI)是儿童常见的疾病之一。二巯丁二酸(DMSA)闪烁扫描被广泛用于评估肾皮质(包括实质缺损)的功能和形态。此外,只有一小部分肾脏缺陷能通过超声波检测出来。我们的目的是检查儿童的 DMSA 闪烁扫描,并确定与肾皮质缺损相关的因素。方法 纳入接受DMSA闪烁扫描的18岁以下患者(2019年11月18日-2023年2月2日,30名儿童)。所有儿童均接受了 99m Tc-DMSA 静脉注射,然后在 3 小时后接受静态平面和单光子发射计算机断层扫描成像。受影响最严重肾脏的皮质检查结果和不同功能被相应分级。Ⅰ级为不超过两个皮质缺损,Ⅱ级为超过两个皮质缺损,缺损之间实质正常,Ⅲ级为全身损害,Ⅳ级为肾脏萎缩,无 DMSA 摄取。肾功能正常是指相对功能在 45% 到 55% 之间,轻度功能减退在 40% 到 44% 之间,功能严重受损在 10% 到 39% 之间,而无功能是指肾功能分化差值小于 10%。然后对所有数据进行统计分析。结果 大部分为女性(53%)。平均年龄为 5.85 岁。尿毒症发病率为 73%。22名儿童患有先天性尿路异常。所有膀胱输尿管反流(VUR)患者均有阳性缺陷。有17名患儿的闪烁照相术显示单侧肾脏(64%)或双侧肾脏(36%)出现异常。17名患儿(57%)分别属于DMSA扫描结果异常类和肾功能正常直至明显受损类。尿崩症与扫描结果异常有明显关联(P < 0.05)。DMSA 扫描结果异常与肾功能差异之间存在明显关联(P < 0.05)。结论 VUR 与 DMSA 闪烁扫描异常、DMSA 扫描结果异常和差异肾功能受损之间存在显著关联。对这些病例应给予特别考虑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Renal Cortical Imaging with Tc-99m DMSA in Children: An Institutional Review
Abstract Background  Urinary tract infection (UTI) is one of the commonly encountered conditions in children. Dimercaptosuccinic acid (DMSA) scintigraphy is widely advocated for functional and morphological evaluation of the renal cortex including parenchymal defect. Moreover, only a small percentage of renal defects are detected by ultrasound. We aimed to examine DMSA scintigraphy of children and identify factors associated with cortical defect. Methods  Patients aged ≤ 18 years old who underwent DMSA scintigraphy (November 18, 2019–February 2, 2023, 30 children) were included. All children received intravenous injections of 99m Tc-DMSA followed by static planar and single-photon-emission computed tomography imaging at 3 hours. Cortical findings and differential functions of the worst affected kidney were graded accordingly. Grade I has no more than two cortical defects, grade II has more than two cortical defects with normal parenchyma between the defects, while grade III is when generalized damage is noted, and grade IV is when a shrunken kidney is seen with no DMSA uptake. Normal functioning kidney is when the relative function at 45 to 55%, mildly reduced function at 40 to 44%, and substantially impaired function at 10 to 39%, while nonfunctioning is when the differential split renal function < 10%. All data were then statistically analyzed. Results  Majority was female (53%). The mean age was 5.85 years. UTI episodes were 73%. Twenty-two children had congenital urinary tract anomalies. All patients with vesicoureteric refluxes (VURs) had positive defects. Scintigraphy showed abnormalities in 17 children affecting unilateral (64%) or both kidneys (36%). There were 17 children (57%) respectively in the abnormal DMSA scan findings category with normal until significant impairment of the functioning kidney category. VURs were significantly associated with abnormal scintigraphy ( p  < 0.05). A significant association was found between abnormal DMSA scan findings and differential renal function ( p  < 0.05). Conclusion  Significant association was noted between VURs and abnormal DMSA scintigraphy, abnormal DMSA scan findings, and impaired differential renal function. Special consideration should be given to these cases.
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来源期刊
World Journal of Nuclear Medicine
World Journal of Nuclear Medicine RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
自引率
16.70%
发文量
118
审稿时长
48 weeks
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