Barbalias G A, Nikiforidis G, Vassilakos P, Liatsikos E N
Department of Urology, University of Patras, Greece.
Urol Res. 1999 Dec;27(6):462-9. doi: 10.1007/s002400050136.
A study was carried out to determine the spatial-temporal distribution of the radiopharmaceutical, 99mTc-DTPA in the kidney and its compartments during renography and the use of compartmental analysis to improve the diagnostic capability of renography. A total of 60 individuals formed three groups: group A consisted of 30 normals taken as controls, group B consisted of 15 patients with unilateral nephropathy, and group C consisted of 15 patients with unilateral obstructive uropathy. This retrospective study was performed by processing of the frames acquired in the various stages of renography and determination of the time distribution of radioactivity in the aorta, the renal parenchyma and the renal pelvis. The data acquired were used to produce three curves instead of one for each kidney and to study renal function as a system of six compartments (aorta, left and right renal parenchyma, left and right renal pelvis, and bladder). In all the above compartments the differences among the three groups were significant and were quantified using the flow coefficients of the aortorenal compartments. The differences between the aortic flow coefficients (k1) were statistically significant not only between normal controls and patients, but also between individuals with parenchymatic dysfunction and patients with pelvocalyceal obstruction. The same differences were seen comparing the pelvocalyceal coefficients (k3) of all three groups. The parenchymatic coefficient (k2) presented statistically significant differences between normals and patients which were not observed between the two groups of patients (B and C). Compartmental analysis thus increases the sensitivity of renography, is objective by utilizing quantitative parameters, enables the separate analysis of the functional behavior of the various renal compartments, and improves the differential diagnosis between parenchymatic dysfunction and pelvocalyceal obstruction.
本研究旨在确定放射性药物99mTc-DTPA在肾图检查期间于肾脏及其各部分的时空分布，并利用房室分析来提高肾图检查的诊断能力。共有60名个体分为三组：A组由30名正常对照者组成，B组由15名单侧肾病患者组成，C组由15名单侧梗阻性尿路病患者组成。本回顾性研究通过处理肾图检查各阶段获取的图像帧以及测定主动脉、肾实质和肾盂中放射性的时间分布来进行。所获取的数据用于为每个肾脏生成三条而非一条曲线，并将肾功能作为一个由六个房室（主动脉、左右肾实质、左右肾盂和膀胱）组成的系统来研究。在上述所有房室中，三组之间的差异均具有显著性，并使用主动脉-肾房室的流量系数进行量化。主动脉流量系数（k1）之间的差异不仅在正常对照者与患者之间具有统计学显著性，而且在实质功能障碍个体与肾盂输尿管梗阻患者之间也具有统计学显著性。在比较所有三组的肾盂流量系数（k3）时也观察到了同样的差异。实质系数（k2）在正常人与患者之间呈现出统计学显著性差异，而在两组患者（B组和C组）之间未观察到这种差异。因此，房室分析提高了肾图检查的敏感性，通过利用定量参数使其具有客观性，能够对各个肾房室的功能行为进行单独分析，并改善了实质功能障碍与肾盂输尿管梗阻之间的鉴别诊断。
