~(99m)Tc-DTPA肾动态显像对移植肾排异反应的监测价值

对13例肾移植病人采用~(99m)Tc-DTPA进行移植肾功能的动态显像。结果表明,3例无阳性症状者显示正常。1例超急性排异示移植肾无血管灌注相,术后病理证实肾坏死。3例急性排异除血管灌注相延缓外,放射性活度低于髂动脉,功能相及膀胱放射性出现时间均延缓,经抗排异治疗其功能是可逆的。6例慢性排异示血管灌注相时放射性分布不均,活度低于髂动脉,膀胱放射性出现时间延缓,说明部分肾单位已受损伤。提示~(99m)Tc-DTPA肾功能动态显像对监测移植肾排异反应的状况及指导临床治疗具有重要意义。

THE VALUE OF ~(99m)Tc-DTPA KIDNEY DYNAMIC IMAGING IN MONITORING REJECTION OF RENAL ALLOGRAFTS

Thirteen renal graft recipients were given ~(99m)Tc-DTPA for their grafted kidneys. The results showed that 3 cases with no positive symptons showed normal renography. In 1 case of hyperacute rejection, no vascular perfusion phase was seen and renal necro- sis was showed by post-operation pathology. In 3 cases of acute rejection the radioactivi- ty in the grafted kidney was lower than that in the iliac artery, besides a delayed vascu- lar perfusion phase. The time of appearance of the functional phase and the bladder ra- dioactivity were both delayed. All these functional impairments could be reversed by an- ti-rejection treatment. Six cases of chronic rejection showed an inhomogeneous distribu- tion of radioactivity in the vascular perfusion phase, a radioactivity lower than that in the liliac artery and a delayed appearance of the bladder radioactivity, which indicated that part of the nephrons had been damaged. Examination of patients of this kind by this method suggests that ~(99m)Tc-DTPA renofunctional dynamic imaging is highly sig- nificant in monitoring the condition of rejection of the transplanted kidney and in guiding clinical treatment.