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。

99Tcm-DTPA Renal Dynamic Imaging on Monitoring Transplanted Kidney

Objective：To describe the characteristics of the transplanted kidney dynamic imaging and to evalu ate the clinical value of ^99Tc^m-DTPA renal dynamic imaging on allografted kidney monitoring. Methods： 28 patients who underwent allogeneic kidney transplantation were examined with ^99Tc^m- DTPA dynamic imaging. Glomerular filtration rate （GFR） and bladder to kidney radioactive counting （B/K） ratio of the transplanted kidney were ac quired. The characteristics of transplanted kidney dynamic imaging were analyzed quantitatively and qualitatively. Results：The perfusion and function of 12 patients with allografted kidney were normal, GFR was （51.5 ± 6.3 ）ml/ min, B/K ratio was ）〉3. The function was superior to perfusion in 6 cases with acute rejection. GFR was （33.4 ± 5.7） ml/min, B/K ratio was〈1. The perfusion and function of 7 chronic rejection cases were impaired symmetri cally. Where GFR was （27.5±2. 1） ml/min, all B/K ratio was 〈1. There is 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 consistant with clinical symptoms or pathology. Conclusions： The blood flow and function of transplanted kidney can be evaluated quantitatively and rapidly by ^99Tc^m-DTPA renal dynamic imaging. ^99Tc^m-DTPA dynamic imaging can identify rejection early, noninvasive, simply and repeated.