移植肾的99Tc^m-DTPA肾动态监测

目的探讨99Tc^m-DTPA肾动态显像在肾移植术后监测中的图像特征和临床价值。方法28例肾移植患者进行99Tc^m-DTPA肾动态显像，同时测定移植肾的肾小球滤过率（GFR）和膀胱放射性计数与肾脏放射性计数比值（B／K值），定性和定量分析肾移植术后的影像特征。结果12例肾移植术后肾血流灌注及功能良好，GFR值为（51．5±6．3）ml／min，B／K均〉3。6例急性排斥反应肾血流灌注受损程度重于功能相，GFR值为（33．4±5．7）ml／min，B／K均〈1。7例慢性排斥反应肾血流灌注和功能相均同时受损，GFR值为（27．5±2．1）ml／min，B／K均〈1。1例超急性排斥反应表现为放射性空白区。2例肾小管坏死肾血流灌注损伤轻于功能相。所有影像表现与临床或病理结果相吻合。结论99Tc^m．DTPA肾动态显像可快速且定量评价移植肾的血流和功能，早期初步鉴别排斥反应的类别且具有无创、简单、重复性强的特点。

Clinical Value of 99Tcm-DTPA Renal Dynamic Imaging on Monitoring Transplanted Kidney

Objective To investigate the characteristics of transplanted kidney dynamic imaging and to evaluate the clinical value of 99Tcm-DTPA renal dynamic imaging on monitoring transplanted kidney. Methods 28 patients who underwent transplantation of allogeneic kidneys were examined with 99Tcm-DTPA dynamic imaging. Glomerular filtration rate （GFR） and bladder to kidney（B/K） ratios of transplanted kidney were acquired by region-of-interests（ROI）. All results were analyzed both quantitatively and qualitatively. Results The perfusion and function of 12 patients with transplanted kidney were normal, GFR were （51.5±6.3 ）ml/min, B/K ratios were 〉 3. The function was superior to perfusion in 6 cases with acute rejection, GFR were （ 33.4 ± 5.7 ） ml/min, B/K ratios were 〈 1. The perfusion and function of 7 chronic rejection cases were impaired symmetrically, GFR were（27.5 ± 2.1 ） ml/min, all B/K ratios were 〈 1.1 case with ultra-acute rejection showed no radioactivity. The perfusion was superior to function in 2 cases with necrosis of renal tubules. All imaging materials accorded with clinical symptoms or pathology. Conclusion The blood flow and function of transplanted kidney can be evaluated both quantitatively and rapidly by 99Tcm- DTPA renal dynamic imaging,99Tcm-DTPA dynamic imaging can identify rejection as well as noninvasive, simply, early and repeatedly.