Tabuchi K, Adachi I, Doi K, Hou N, Komori T, Nakata Y, Matsui R, Sueyoshi K, Narabayashi I
Department of Radiology, Osaka Medical College.
Kaku Igaku. 1999 Jan;36(1):15-22.
It is difficult to evaluate renal function with 99mTc-MAG3 renography in both adult and pediatric patients. We examined 109 pediatric patients with various renal diseases using 99mTc-MAG3 renography. Tenal diseases were classified as follows: 9 vesicoureteral reflux, 4 ureteropelvic junctional stenosis, 3 double pelvis, 23 hydronephrosis, 4 glomerulonephritis, 4 nephrotic syndrome, 24 hemolytic uremic syndrome, 10 others; and 24 patients without abnormal findings on other examinations. After hydration and sedation, 100-200 MBq of 99mTe-MAG3 was injected intravenously. All patients were placed in the supine position, and dynamic data acquisition at 12 sec/frame x 100 frames was performed from the back. The renograms were prepared with the ROIs (regions of interest) set to include the entire kidney. Tmax and T1/2 of renograms were measured for 26 kidneys with no abnormal findings. The correlations between Tmax or T1/2 and age (days after birth) were determined by a linear or logarithmic function. The logarithmic function (Y = 7.49 - 0.56 logeX, r2 = 0.134) yielded a higher correlation than did the linear function (Y = 5.16 - 0.00194X, r2 = 0.089) between Tmax and age. For T1/2 and age (days after birth), the linear function (Y = 8.07 - 0.00451X, r2 = 0.222) yielded a higher correlation than the logarithmic function (Y = 11.9 - 0.986 logeX, r2 = 0.192). Our findings suggest that prolonged Tmax is normalized more rapidly than T1/2 after birth in infants. A delayed excretion phase is not suggestive of renal dysfunction, but is characteristic of renograms in pediatric patients. Abnormality was detected in all patients with hydronephrosis using 99mTc-MAG3 renography. On the other hand, a quantitative study was required because renography detected no abnormality for some of patients with disorders of renal parenchyma.
对于成人和儿童患者，使用99mTc-MAG3肾图评估肾功能都很困难。我们使用99mTc-MAG3肾图检查了109例患有各种肾脏疾病的儿科患者。肾脏疾病分类如下：9例膀胱输尿管反流、4例肾盂输尿管连接处狭窄、3例重复肾盂、23例肾积水、4例肾小球肾炎、4例肾病综合征、24例溶血尿毒综合征、10例其他；以及24例在其他检查中无异常发现的患者。在水化和镇静后，静脉注射100 - 200 MBq的99mTe-MAG3。所有患者均取仰卧位，从背部以12秒/帧×100帧进行动态数据采集。肾图通过设置包括整个肾脏的感兴趣区（ROI）来制备。对26个无异常发现的肾脏测量肾图的Tmax和T1/2。通过线性或对数函数确定Tmax或T1/2与年龄（出生后天数）之间的相关性。对数函数（Y = 7.49 - 0.56 logeX，r2 = 0.134）在Tmax与年龄之间产生的相关性高于线性函数（Y = 5.16 - 0.00194X，r2 = 0.089）。对于T1/2与年龄（出生后天数），线性函数（Y = 8.07 - 0.00451X，r2 = 0.222）产生的相关性高于对数函数（Y = 11.9 - 0.986 logeX，r2 = 0.192）。我们的研究结果表明，婴儿出生后Tmax延长比T1/2更快恢复正常。排泄期延迟并不提示肾功能障碍，而是儿科患者肾图的特征。使用99mTc-MAG3肾图在所有肾积水患者中均检测到异常。另一方面，由于肾图在一些肾实质疾病患者中未检测到异常，因此需要进行定量研究。
