99mTc-DTPA肾动态显像对IVP不显影患肾功能的评价

目的：探讨放射性核素99mTc-DTPA肾动态显像对静脉肾盂造影（IVP）不显影患肾功能评价的临床意义。方法：受检者共64例，临床诊断共66只患肾。99mTc-DTPA静脉注射后SPECT肾动态显像，获取血流灌注和功能显像图像并测定分肾GFR值。结果：IVP不显影的患肾99mTc-DTPA动态显像结果表现为0级2例，GFR均值为53.7ml/min；I级3例，GFR均值为35.8ml/min；II级7例，GFR均值为21.1ml/min；III级36例，GFR均值12.8ml/min；IV级18例，GFR均值为7.8ml/min。对99mTc-DTPA动态显像提示另一肾脏功能正常或轻度受损的患者手术切除患肾20例，其余行保留肾脏治疗手段，大部分功能恢复良好。结论：99mTc-DTPA肾动态显像对评价肾功能，特别是对IVP不显影的单肾功能判定有重要的临床价值，此法具有简便、无创伤、灵敏度高及可重复性的特点。

Study of 99mTc-DTPA renal dynamic imaging for renal function as IVP detection failed

Objective: To investigate the clinical significance of ~(99m)Tc-DTPA renal dynamic imaging in evaluating renal function as intravenous pyelography(IVP) detection failed. Methods: Sixty-six abnormal kidneys in 64 patients which IVP detection failed were accepted for ~(99m)Tc-DTPA renal dynamic imaging. Results: ~(99m)Tc-DTPA renal dynamic imaging demonstrated that all the IVP detection failed kidneys had poor function and nonfunction, detailed as: grade 0 in 2 cases, grade I in 3 cases, grade II in 7 cases, grade III in 36 cases, grade IV in 18 cases. And the average GFR was 53.7ml/min, 35.8ml/min, 21.1ml/min, 12.8ml/min and 7.8ml/min respectively. Twenty cases which ~(99m)Tc-DTPA renal dynamic imaging showed normal function or function slightly damaged on the contralateral kidney, the affected kidney received nephrectomy, others accepted expectant treatments and mostly with good recovery. Conclusion: ~(99m)Tc-DTPA renal dynamic imaging is an ideal method to assess preoperative renal function especially the single renal function in IVP detection failed patients. It is a simple, noninvasive, with high-sensitivity and repeatability.