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1.
利尿肾动态显像在小儿先天性泌尿系统畸形中的应用   总被引:1,自引:0,他引:1  
目的 探讨利尿肾动态显像(DR)在小儿先天性泌尿系统畸形诊断及随访评价中的应用价值.方法 163例确诊为先天性泌尿系统畸形的患儿均行DR检查,其中97例术后复查DR.观察泌尿系统各部位的形态特征,并根据DR结果对肾积水进行分度;对随访结果进行定性和定量评估.结果 泌尿系统畸形各有其DR影像改变特征.术后随访见肾功能明显提高;肾重复与输尿管畸形预后较好,尿道瓣膜预后较差.结论 DR可显示先天性泌尿系统畸形的特征性改变;用于定性或定量评估随访结果,简便可靠.  相似文献   

2.
99TCm-DTPA肾动态显像评价新生儿肾积水肾功能   总被引:3,自引:2,他引:1  
目的 探讨用99Tcm DTPA肾动态显像评价新生儿肾积水肾功能的价值。方法 用99Tcm DTPA肾动态显像测定 15例患儿 18只患肾和 12只正常肾的肾小球滤过率 (GFR) ,与同期血尿素氮(BUN)、血清肌酐 (SCr)、血红蛋白 (Hb)结果进行相关分析。结果 ①中、重度新生儿肾积水GFR与Hb呈正相关 (r=0 4 14、0 6 6 7,P <0 0 5、<0 0 1)。②GFR与BUN无相关性。③中、重度新生儿肾积水GFR与SCr呈显著负相关 (r=- 0 4 90、- 0 75 6 ,P <0 0 5、<0 0 1)。④轻度新生儿肾积水相对肾功能与正常肾比较差异无显著性 (P >0 0 5 ) ;中度新生儿肾积水相对肾功能 [(38 91± 8 70 ) % ]在4 0 %以下 ,重度新生儿肾积水 [(2 9 2 3± 7 37) % ]在 30 %以下 ,与正常肾比较 ,中、重度新生儿肾积水相对肾功能均明显下降 (P <0 0 5、<0 0 1)。结论 99Tcm DTPA肾动态显像测定GFR是检测新生儿肾积水肾功能的理想指标。SCr可作为肾功能损害的检测指标 ,尤其对中、重度新生儿肾积水。BUN不适于诊断新生儿肾积水。临床诊断明确的中、重度新生儿肾积水应早期手术治疗 ,以防肾功能进一步损害。  相似文献   

3.
目的探讨^99Tc^m-双半胱氨酸(EC)利尿。肾动态显像(DR)在小儿先天性肾盂积水手术前肾功能评价和术后随访中的临床价值。方法回顾性分析40例肾盂积水患儿的DR(常规方法中第15分钟注射呋塞米),对患肾血流灌注率(BPR)及有效肾血浆流量(ERPF)、肾盂积水分度、肾图曲线和动态显像图进行手术前后的比较。符合正态分布数据间比较采用t检验,等级资料数据间比较采用非参数检验。结果(1)40只患肾的BPR术前为(34.05±11.07)%,术后为(40.04±8.56)%,平均提高5.99%(t=-5.13,P〈0.01)。患肾的ERPF术前为(57.81±34.32)ml/min,术后为(70.29±5.37)ml/min,平均提高12.48ml/min(t=-4.35,P〈0.01)。(2)40只患肾的。肾盂积水分度的平均秩和术前为47.21,术后为33.79(Z=-2.64,P〈0.01)。(3)随着积水程度的加重,患肾形态增大,肾实质变薄,肾内放射性缺损范围增大,对利尿试验的反应明显减弱直至无反应。(4)术前DR诊断肾盂输尿管连接处梗阻(UPJO)37例,输尿管膀胱入口处梗阻(UVJO)3例,术前梗阻的定位均为手术证实。结论DR是评价小儿先天性肾盂积水的一种可靠方法,能够准确反映病情、指导治疗,并监测手术疗效。  相似文献   

4.
目的探讨结石梗阻出现化脓性肾盂肾炎患者行内镜结石清除术手术后肾功能转归的影响因素。方法选取自2014年4月至2017年5月收治的134例结石梗阻出现化脓性肾盂肾炎患者为研究对象,患者均为初次诊断,并行内镜结石清除术。出院后,患者均行12个月随访。根据患者血肌酐水平将患者分为肾功能转归组(血肌酐<110μmol/L,n=73)与肾功能损伤组(血肌酐≥110μmol/L,n=61)。记录患者临床资料,行血常规、尿常规、肾小球滤过率等指标检测及超声、CT检查,对患者肾功能进行评估,分析患者肾功能转归的影响因素。结果 134例患者术后出现结石残留21例(15. 7%),围术期出现炎症反应102例(76. 1%),尿源性败血症3例(2. 2%)。研究过程中,未出现入住重症监护室或死亡患者。随访12个月时,患者血肌酐为(94. 6±21. 3)μmol/L,低于术前的(109. 3±23. 6)μmol/L,差异有统计学意义(P <0. 05)。单因素分析结果显示,患者年龄、结石梗阻时间、术前肾小球滤过率、肾周感染与患者术后肾功能转归有关(P <0. 05)。多因素Logistic回归分析结果显示,患者年龄、结石梗阻时间、术前肾小球滤过率、肾周感染是结石梗阻出现化脓性肾盂肾炎患者术后肾功能转归的独立危险因素(P <0. 05)。结论结石梗阻出现化脓性肾盂肾炎患者在控制感染的前提下行内镜取石术较为安全,术后患者预后情况较好。患者年龄、结石梗阻时间、术前肾小球滤过率、肾周感染是术后肾功能转归的独立危险因素。  相似文献   

5.
目的 :评价CTU检查小儿先天性UPJ梗阻术前诊断及术后疗效观察的价值。材料和方法 :对IVU检查不显影或IVU、BUS诊断不明确及临床高度怀疑泌尿道畸形患儿行CTU检查。结果 :重度肾积水 43只 ,CTU、IVU及BUS术前对其梗阻部位诊断的手术符合率分别为 98%、2 1%及 6 3%。术后肾实质厚度净增长中度肾积水为 0 .2 1± 0 .16 ,重度肾积水为0 .38± 0 .19,说明术后肾实质厚度净增长重度肾积水大于中度肾积水 ;手术前后肾盂显影时间分布构成比表明 ,术后肾分泌及排泄功能也明显改善。结论 :CTU检查适用于先天性尿路梗阻伴肾功能损伤的患儿 ,特别是UPJ梗阻患儿术前术后的检查 ,CTU可作为IVU不显影或BUS诊断不明确的一种极好的替代手段。  相似文献   

6.
目的 探讨64层螺旋CT测量肾积水体积用于评估梗阻性肾积水患者肾功能的价值.方法 选取在本院3 d内同时行单光子发射计算机体层成像(SPECT)肾动态显像及64层螺旋CT平扫的梗阻性肾积水患者共176例.根据SPECT测得的肾小球滤过率(GFR)将其分为肾功能正常组、肾功能轻度受损组、肾功能中度受损组及肾功能重度受损组.同时利用CT三维重建技术测量各组患者的肾积水体积大小,然后对比各组间肾积水体积的差异,并分析肾积水体积与GFR的相关性.结果 4组患者肾积水体积分别为(31.47±3.81) cm3、(83.43±7.81) cm3、(208.53±15.47) cm3 及(577.31±61.32) cm3 ,差异有统计学意义(P<0.01);组间两两比较除肾功能正常组与肾功能轻度受损组外,其余各组间差异均有统计学意义(P<0.01);肾积水体积与肾脏GFR具有良好的相关性(r=-0.614).结论 64层螺旋CT测得的肾积水体积与SPECT测得的GFR有较好的相关性,能在一定程度上反映肾积水患者的肾脏功能.  相似文献   

7.
肾动态显像对小儿先天性肾积水手术前后患肾功能的评价   总被引:1,自引:0,他引:1  
应用^99mTc-DTPA对12例小儿单侧先天性肾积水手术前后进行肾动态显像及单肾功能测定,结果患肾功能术后较术前明显提高,且发现术前功能降低越明显者,术后功能相对提高越显著,但部分病例患肾功能仍明显低于正常。  相似文献   

8.
夏建峰  黄泽和  陈松 《放射学实践》2021,36(10):1259-1264
【摘要】目的:探索利用双肾增强CT评估肾积水患者肾脏功能受损程度。方法:回顾性分析74例双肾增强CT检查数据,其中肾积水组(双肾积水患者)38例,无肾积水组(双肾无积水者)36例。采用独立样本t检验或Mann-WhitneyU检验比较各项参数在两组间的差异,然后应用Pearson或Spearman检验分析肾积水组患者增强CT各项参数与估算肾小球滤过率(eGFR)的相关性。结果:肾积水组的eGFR、皮质期双肾皮质强化均值、髓质期双肾皮质强化均值、髓质期双肾髓质CT升高均值、髓质期双肾髓质强化均值、皮质期双肾皮质强化率、髓质期双肾皮质强化率、髓质期双肾髓质强化率、双肾皮质厚度均值及双肾实质厚度均值都低于无肾积水组,而髓质期双肾皮质CT升高均值高于无积水组。以上差异均有统计学意义(P<0.05)。肾积水组eGFR与皮质期双肾皮质强化均值(r=0.663,P<0.001)、皮质期双肾髓质强化均值(r=0.344,P<0.05)、髓质期双肾皮质强化均值(r=0.562,P<0.001)、髓质期双肾髓质CT升高均值(r=0.489,P<0.01)、髓质期双肾髓质强化均值(r=0.601,P<0.001)、皮质期双肾皮质强化率(r=0.720,P<0.001)、髓质期双肾皮质强化率(r=0.725,P<0.001)、髓质期双肾髓质强化率(r=0.607,P<0.001)均具有相关性,其中以髓质期双肾皮质强化率(r=0.725,P<0.001)为最。结论:双肾增强CT能够评估肾积水患者肾功能受损程度,为临床诊治提供参考信息。  相似文献   

9.
目的探讨低位恶性梗阻性黄疸介入引流治疗与预后相关的危险因素。方法回顾性分析2005年9月—2011年12月在南京医科大学第一附属医院介入放射科接受经皮介入引流治疗的低位恶性梗阻性黄疸患者242例,选择性别、年龄、肿瘤类型、术前梗阻时间、术前感染、引流方式、肝功能Child-Pugh评分,血清总胆红素、白蛋白、肌酐、术后胆红素下降程度以及术后是否针对肿瘤治疗作为研究参数,评估影响该类患者生存期的相关危险因素。结果单因素分析显示术前感染(P=0.005)、肝功能Child-Pugh评分(P=0.003)、血清肌酐(P=0.044)、血清胆红素下降程度(P=0.000)及术后是否行抗肿瘤治疗(P=0.014)5个因素是影响该类患者生存期的相关因素;多因素Logistic回归分析显示术前感染(P=0.041)、肝功能Child-Pugh评分≥10分(P=0.019)及术后未行抗肿瘤治疗(P=0.039)是影响该类患者生存期的重要因素。结论在对低位恶性梗阻性黄疸介入引流治疗时,术前感染、肝功能Child-Pugh评分及术后是否针对肿瘤治疗可能是影响患者生存期的相关因素,对评估该类患者的预后有重要的参考意义。  相似文献   

10.
目的探讨SPECT肾动态显像在诊断小儿先天性肾盂积水的价值.方法回顾性分析肾盂积水患儿30例,采用99mTc-DTPA肾动态显像方法,部分患儿静脉注射速尿,其中12例作手术前后比较.定量指标有高峰摄取率(PUR),肾血流灌注率(BPR),半排时间(T1/2)结果BPR随肾盂积水程度加重而明显下降,重度积水为16.8%±6.8%,中度积水为35.1%±6.9%,轻度积水为40.6%±9.2%.PUR在重度积水时为21.6%±12.9%.12例患儿手术后其中10例BPR明显升高,术后T1/2明显改善.结论SPECT可准确反映肾盂积水和肾功能受损程度,两者呈正相关,术后肾功能改善情况和应用速尿能正确判断集尿系统有无梗阻存在.  相似文献   

11.
目的:应用经皮肾镜手术前后肾阻力指数(RI)的变化来评价肾功能。方法采用随机、平行对照的临床研究方法,对纳入本研究的40例患者,记录经皮肾镜手术前、手术后0.5 h、手术后2周时双侧肾上、中、下段肾叶间动脉阻力指数,以及血液肌酐、尿素氮数据,分析肾动脉阻力指数与肾功能变化的关系。结果①患侧肾在经皮肾镜术前2 h与术后0.5 h叶间动脉RI值相比较,差异有统计学意义(t=2.72,P<0.05),术后1周的叶间动脉RI值相比较,差异有统计学意义(t=3.57,P<0.05),而健侧肾在经皮肾镜术前与术后0.5 h叶间动脉RI值相比,差异无统计学意义(t=1.63,P>0.05),而与术后2周叶间动脉RI值相比,差异有统计学意义(t=3.31,P<0.05);②患者的术前2 h血液中肌酐与术后0.5 h相比,差异无统计学意义(t=1.33,P>0.05),而与术后1周相比,差异有统计学意义(t=3.86,P<0.05),患者的术前2 h血液中尿素氮与术后0.5 h相比,差异无统计学意义(t=2.01,P>0.05),而与术后1周相比,差异有统计学意义(t=3.57,P<0.05);③患者健侧肾术前、术后RI值与肌酐、尿素氮变化无相关性,而患侧肾术前、术后RI值与肌酐、尿素氮的变化呈负相关(r=-0.37,P<0.05)。结论可以应用经皮肾镜手术前后肾RI的变化来评价肾功能的变化,为泌尿科微创取石手术提供临床依据。  相似文献   

12.
Distraction osteogenesis is an effective method for lengthening long bones and filling bone defects that result from bone resection. Insufficiency of bone consolidation in the distraction segment is problematic. In this study, we examined whether 3-phase bone scintigraphy can predict the outcome of distraction osteogenesis. We also investigated the effects of chemotherapy and surgical treatment on distraction osteogenesis. METHODS: We performed 3-phase bone scintigraphy on 60 patients (9 high-grade malignant bone tumors as group A, 11 low-grade malignant or benign tumors as group B, 40 nontumoral conditions as group C) with distraction osteogenesis at the lengthening phase of the long bones. By setting the region of interest on the distraction segment and contralateral normal area, we calculated the perfusion index (PI), the uptake ratio of the blood-pool image (BPR), and the uptake ratio of the delayed image (DR). Patients were classified into poor and good consolidation groups from the radiographic findings of the distraction segment. RESULTS: Good to fair correlations were obtained between the PI and BPR, the PI and DR, and the BPR and DR (r = 0.65, 0.45, and 0.57, respectively). The PI and BPR indicated no significant differences among group A-C (1.7 +/- 0.6, 2.1 +/- 0.7, and 1.8 +/- 0.8 in PI, respectively; 1.8 +/- 1.1, 1.9 +/- 0.5, and 2.0 +/- 0.7, in BPR, respectively). The DR of group A (2.4 +/- 1.2) was significantly lower than that of group B (6.3 +/- 1.8; P = 0.001) and group C (5.9 +/- 2.8; P < 0.001). Eleven patients were classified in the poor consolidation group. The other 49 patients showed good consolidation. The poor consolidation group showed lower values in all indices obtained by 3-phase bone scintigraphy than the good consolidation group. The optimal cutoff levels, sensitivity, specificity, and accuracy of each index for detection of patients with poor consolidation were as follows: 1.1, 36%, 90%, and 80% in the PI, respectively; 1.2, 55%, 94%, and 87% in the BPR, respectively; and 2.2, 82%, 96%, and 93% in the DR, respectively. CONCLUSION: Three-phase bone scintigraphy is a promising method for the assessment of distraction osteogenesis. The delayed image of 3-phase bone scintigraphy, especially, is an excellent modality for predicting the outcome of distraction osteogenesis.  相似文献   

13.
AIM: Pyeloplasty is a widely accepted method for the treatment of ureteropelvic junction obstruction (UPJO). Surgery has long been thought to affect postoperative renal function. However, controversies still exist on the functional studies that can be used to indicate which renal units will benefit from surgery. In this study, the correlation between differential renal function (DRF) and other preoperative parameters was examined to determine which parameter more accurately predicts recovery of renal function in adult obstructed kidneys. MATERIALS & METHODS: In this study, the authors evaluated 32 patients with UPJO. In all patients, standart diuretic Tc-99m DTPA renal scans were performed preoperatively and 6 months after surgery. Patients were divided into two groups according to the preoperative DRF (> or = 30%, n = 22, group I and < 30%, n = 10, group II). Second type classification was made according to the postoperative DRF improvement as improved (group A, n = 13) and not improved (group B, n = 19). These groups were then compared regard to variables which were defined as symptoms, age at operation and ultrasonographic findings. We also evalulated whether preoperative parenchymal function is important to predict improvement in drainage half-time (T1/2). RESULTS: While preoperative drainage half-time was 39.6 +/- 15.9 minutes, postoperative half-time decreased to 16.9 +/- 6.8 minutes (p < 0.001). The mean DRF did not improved significantly after surgery compared with preoperative values (32.03 +/- 9.42% versus 36.16 +/- 9.60%). When comparing the patients with preoperative DRF > or = 30% (group I, DRF 38 +/- 0.8%) to those who had an initial DRF below 30% (group II, DRF 22.8 +/- 5.2%), postoperative DRF was 41.22 +/- 5.72 in group I and 25.00 +/- 6.22 in group II. The difference was significant (p < 0.01). The patients in group I and II showed improvement in 50% and 20%, respectively. Age, clinical presentation and ultrasonographic findings did not affect functional outcome after pyeloplasty. We could not find any correlation between preoperative DRF and the degree of improvement in T1/2. CONCLUSION: Renal function improves after pyeloplasty with regard to the initial level of split renal function in adult obstructed kidneys. Improvement may not be observed especially in patients with DRF less than 30%.  相似文献   

14.
PURPOSE: This study was designed to validate a simple scoring system for evaluating fluorodeoxyglucose (FDG) positron emission tomographic (PET) scans that can be used routinely in patients undergoing the clinical assessment of cognitive impairment. METHODS: The FDG-PET scans of 106 patients with cognitive impairment (65 with Alzheimer disease, 16 with frontal lobe dementia, and 25 atypical cases) were acquired using the PENN-PET scanner 40 minutes after the intravenous administration of 8 mCi FDG. Metabolic activity in various anatomic structures of the brain was scored using the following qualitative scale: 4 = normal; 3 = mildly decreased; 2 = moderately decreased; 1 = severely decreased; and 0 = no activity. Regions of interest were also placed over these regions to obtain a quantitative value. Two distinct scores were obtained. Values for visual and sensorimotor cortices, thalami, basal ganglia, and cerebellum comprised score I. Score II consisted of the values for the frontal, temporal, and parietal cortices. The qualitative metabolic imaging severity rating scale (MISRS) was compared with a quantitative MISRS (obtained from the region-of-interest analysis of the same structures). The MISRS was then compared with the results from the Mini-Mental Status Examination (MMSE) and the Dementia Severity Rating Score (DSRS). RESULTS: In all patients, the qualitative MISRS scores correlated significantly with the quantitative MISRS (r = 0.73, P < 0.0001). In all patients with cognitive impairment, the qualitative and quantitative MISRS scores correlated significantly with the DSRS and the MMSE (P < 0.001). In patients with Alzheimer disease, the qualitative and quantitative MISRS significantly correlated with the DSRS and MMSE. CONCLUSION: A simple and practical rating scale can be used to assess the severity of cognitive impairment in patients with different types of dementing illnesses.  相似文献   

15.
PURPOSE: To investigate whether 201Tl uptake is associated with cell proliferation and angiogenesis in non-small-cell lung carcinoma (NSCLC). METHODS: Eighty-four patients with scheduled NSCLC underwent 201Tl single photon emission computed tomography (SPECT) imaging: 15 min (early scan) and 240 min (delayed scan) after intravenous injection of 111 MBq of 201Tl chloride. 201Tl indices were calculated on early images (early ratio: ER) and delayed images (delayed ratio: DR). The retention index (RI) was also calculated from these two parameters. Using surgically resected cancer specimens (54 adenocarcinoma, 24 squamous cell carcinoma (SCC), six large-cell carcinoma), immunohistochemical stains for both Ki-67 (MIB-1 index) and CD34 were performed to examine the proliferative activity and the micro-vessel density (MVD), respectively. RESULTS: The mean value of 201Tl index was 1.69+/-0.77 (ER) and 2.31+/-1.08 (DR). The average RI was 42.6+/-42.9%, respectively. Both DR and RI positively correlated with MIB-1 index (r = 0.68, P < 0.05 and r = 0.52, P < 0.05). When we analyse adenocarcinoma and SCC separately, there was a significant positive correlation (r = 0.62, P < 0.05) between RI and MIB-1 index in adenocarcinoma but not in SCC (r = 0.20, P = NS). The value of ER positively correlated with MVD (r = 0.75, P < 0.05). It demonstrated strong positive correlation with both histological types (adenocarcinoma: r = 0.80, P < 0.05, SCC: r = 0.66, P < 0.05). CONCLUSION: 201Tl SPECT imaging is effective non-invasive method for assessing both the proliferation and the angiogenesis in NSCLC. Both DR and RI are useful indicators for assessing cancer cell proliferation in lung adenocarcinoma. ER is a useful marker for assessing the tumour angiogenesis in NSCLC.  相似文献   

16.
Ultrasound (US) imaging of the kidneys has greatly improved in recent years with introduction of wideband transducers and advances is beamformer technology. US is often the first imaging technique to be employed in patients with renal failure, haematuria or proteinuria, after clinical and laboratory evaluation. After conventional US evaluation, Doppler US (DUS) and resistive indices (RIs) analysis provide renal functional evaluation. Anyway, both sensitivity and specificity of conventional US and DUS in renal parenchymal disease evaluation remains low. In the initial or mild clinical stages of renal parenchymal diseases, kidneys may present normal US morphological appearance and normal RIs values, whereas different renal parenchymal diseases may reveal similar appearance on US and DUS evaluation. Besides, different renal parenchymal diseases may present some distinct features on conventional US and DUS with colour Doppler (CD) and power Doppler (PD) evaluation, even though percutaneous renal biopsy is often necessary to reach definite diagnosis. Renal vasculitides and tubular-interstitial nephropathies are more frequently identified by conventional US and DUS than glomerular nephropathies, since glomerular component accounts only for 8% of the renal parenchyma, whereas the highest percentage is occupied by vascular and tubulo-interstitial component. Follow-up of acute renal failure, during and after medical treatment, is the most useful field of employment of conventional US and DUS techniques, since a progressive lowering of RIs is correlated to a progressive recovery of renal function.  相似文献   

17.
目的 探讨99Tcm-二亚乙基三胺五乙酸(99Tcm-DTPA)肾动态显像在单侧肾脏功能严重受损患者中的应用.方法 应用99Tcm-DTPA肾动态显像,测定82例单侧肾脏功能严重受损患者的对侧肾脏肾小球滤过率(GFR),并将其与血清肌酐(SCr)值进行相关性分析,同时对对侧肾脏功能受损的病因进行分析.结果 对侧肾GFR与SCr值呈负相关(r=-0.643,P<0.001);在一侧肾脏功能严重受损患者中,肾结石和泌尿系移行细胞肿瘤患者的对侧肾脏易受损害.结论 单侧肾脏功能严重受损患者有必要通过99Tcm-DTPA肾动态显像密切观察对侧肾脏情况,以便及时治疗,防止对侧肾功能的衰竭.  相似文献   

18.
目的 比较99Tcm-二亚乙基三胺五乙酸(99Tcm-DTPA)肾动态显像和血清胱抑素C测定两种方法在评价肾小球滤过功能中的差别.方法 随机抽取100例患者,其中高血压病患者38例、肾脏病患者35例、动脉硬化性闭塞症患者10例、糖尿病患者9例、其他疾病患者8例.分别通过99Tcm-DTPA肾动态显像法和血清胱抑素C测定法评估肾小球滤过功能.结果 两种方法所测得的肾小球滤过率(GFR)差异无统计学意义(t=1.591,P>0.05),且呈线性相关(r=0.809,P<0.01);放射性核素肾动态显像法在测定GFR的同时,还可以获得分肾功能,观察双肾血流灌注和排泄状况.结论 用99Tcm-DTPA肾动态显像与血清胱抑素C测定两种方法评估GFR,结果无显著差异,且相关性很好.前者可以获得分肾功能,对肾功能状态的评估更为全面;而后者测定方法简便、省时,且价廉,更适合于对临床患者肾功能的筛查.  相似文献   

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