临床儿科杂志 ›› 2014, Vol. 32 ›› Issue (3): 232-234.

• 综合报道 • 上一篇    下一篇

99mTc-EC肾动态显像在儿童肾瘢痕诊断中的价值

冯阳1, 苏潇2, 李佳宁1   

  1. 1.上海交通大学医学院附属新华医院核医学科(上海 200092);
    2.上海交通大学医学院附属第三人民医院放射科(上海 201999)
  • 收稿日期:2013-09-21 出版日期:2014-03-15 发布日期:2014-03-15

Value of 99mTc-EC dynamic renography in diagnosis of renal scars in children 

FENG Yang1, SU Xiao2, LI Jianing1    

  1. (1. Department of Nuclear Medicine, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China; 2. Department of Radiology, The Third Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 201999, China)
  • Received:2013-09-21 Online:2014-03-15 Published:2014-03-15

摘要:

 目的 探讨99mTc-EC肾动态显像在尿路感染患儿肾瘢痕诊断中的价值。方法 回顾性分析同期行99mTc-EC肾动态显像和99mTc-DMSA肾静态显像的67例尿路感染患儿的显像资料,以99mTc-DMSA肾静态显像结果为金标准,分析比较99mTc-EC肾动态显像与尿路感染、肾积水与肾瘢痕的关系。结果  99mTc-EC肾动态图起始2 min叠加图像诊断肾瘢痕的灵敏性是80.28%,特异性是88.89%,阳性似然比为7.23。采用99mTc-DMSA肾静态显像诊断肾瘢痕,发现与上尿路排泄通畅和排泄延缓的患儿相比,上尿路排泄梗阻患儿的肾瘢痕形成概率较高,差异有统计学意义(P<0.05);但积水程度不同患儿的肾瘢痕发生概率的差异无统计学意义(P>0.05)。结论 对尿路感染患儿,99mTc-EC肾动态显像早期叠加图像诊断肾瘢痕形成的灵敏性和特异性均较高,99mTc-EC肾动态显像提供的上尿路排泄情况对肾瘢痕形成的诊断具有一定价值。

Abstract:  Objective To evaluate the diagnostic value of 99mTc-EC dynamic renography for renal scars in children with urinary tract infection. Methods The 99mTc-EC and 99mTc-DMSA renographic results of 67 children diagnosed with urinary tract infection were retrospectively studied. In comparison with 99mTc-DMSA cortical images, the value of 99mTc-EC dynamic renography for the diagnosis of urinary tract infection, hydronephrosis and renal scars was analyzed. Results The sensitivity and specificity of the initial 2 minutes summed images in the 99mTc-EC images for the diagnosis of renal scars was 80.28% and 88.89% respectively, and the likelihood ratio was 7.23. Renal scars were more likely to be formed in patients with obstructed upper urinary tracts, as compared with patients with unobstructed upper urinary tracts and unsmooth upper urinary tracts (P<0.05). The incidence of renal scar formation was not significantly different among groups with hydronephrosis of varying degrees (P>0.05). Conclusions For children with urinary tract infection, the diagnostic sensitivity and specificity of the initial summed images of 99mTc-EC dynamic renography are high. Furthermore, the excretion of upper urinary tract showed by 99mTc-EC dynamic renography is valuable for the diagnosis of renal scars.