Schiepers C, Mesotten L, Proesmans W, Vereecken R, Verbruggen A, de Roo M
Department of Molecular and Medical Pharmacology, UCLA School of Medicine, Los Angeles, CA 90095, USA.
Nucl Med Commun. 2001 Feb;22(2):217-24. doi: 10.1097/00006231-200102000-00014.
To evaluate kidney function before and after surgical correction of vesicoureteral reflux. The long-term effect was measured with quantitative nephro-scintigraphy using 99Tcm labelled dimercaptosuccinic acid (99Tcm-DMSA).
Forty-five children with a history of urinary tract infections due to vesicoureteral reflux (VUR) were studied. VUR grade was determined with contrast voiding cystourethrography. Planar scintigraphy was performed with 99Tcm-DMSA and uptake measured as a percentage of injected dose. Kidney function was evaluated at baseline and 5 years after corrective surgery.
Three months after surgery, persistent mild reflux was found in eight of 76 treated renal units. Kidney uptake at 5-year follow-up was unchanged in the majority of children, indicating preservation of renal function found at baseline. The split renal function showed an excellent correlation (r = 0.99) between baseline and follow-up studies (regression slope 1.01). Percentage uptake had a regression slope of 0.89 significantly different from unity (P<0.05). Empirical kidney-depth correction techniques were compared. The scintigraphic pattern worsened in six kidneys, indicative of increased scarring in a minority of children.
Planar nephro-scintigraphy with 99Tcm-DMSA was well tolerated in our paediatric population, and appeared appropriate to evaluate kidney function in time. After surgical correction of VUR, the baseline function was maintained in 94% of kidneys.
评估膀胱输尿管反流手术矫正前后的肾功能。采用99锝标记的二巯基丁二酸（99Tcm-DMSA）定量肾闪烁扫描法测量长期效果。
对45例因膀胱输尿管反流（VUR）有尿路感染病史的儿童进行研究。通过排尿性膀胱尿道造影确定VUR分级。用99Tcm-DMSA进行平面闪烁扫描，并将摄取量测量为注射剂量的百分比。在矫正手术前及术后5年评估肾功能。
术后3个月，在76个接受治疗的肾单位中有8个发现持续性轻度反流。大多数儿童在5年随访时肾脏摄取情况未变，表明基线时发现的肾功能得以保留。分肾功能在基线和随访研究之间显示出极好的相关性（r = 0.99）（回归斜率为1.01）。摄取百分比的回归斜率为0.89，与1显著不同（P<0.05）。比较了经验性肾脏深度校正技术。6个肾脏的闪烁扫描图像恶化，表明少数儿童瘢痕增加。
99Tcm-DMSA平面肾闪烁扫描在我们的儿科人群中耐受性良好，似乎适合及时评估肾功能。膀胱输尿管反流手术矫正后，94%的肾脏维持了基线功能。
