Ardela Díaz E, Miguel Martínez B, Gutiérrez Dueñas J M, Díez Pascual R, García Arcal D, Domínguez Vallejo F J
Servicio de Cirugía Pediátrica, Hospital General Yagüe, Avda. del Cid 96, 09005 Burgos.
Cir Pediatr. 2002 Jul;15(3):118-21.
In congenital obstructed hydronephrosis, the assessment of the differential renal function (DRF) is essential to provide a prognosis or to determine surgical treatment. The most reliable method to measure the differential renal function is the isotopic study with DMSA. The MAG-3 is employed to evaluation renal elimination, although in the minutes 1-3 it also measures the differential renal function.
We compared the estimation of differential renal function by 99Tc-dimercapto-succinic acid (DMSA) and 99Tc-mercaptoacetyltriglycyne (MAG-3) methods in congenital unilateral uropathies.
We reviewed the results of 138 isotopic studies of children (age range: 0-9 years) with congenital unilateral uropathies: 67 cases were obstructed and 71 non-obstructed. In all of them were carried out match tests pairs with DMSA and MAG-3. Both series were divided into 4 groups: 1) DRF < 40%, 2) DRF 40-45%, 3) DRF 46-50% and 4) DRF > 50%. The measurement differential renal function correlation by DMSA and MAG-3 were analysed.
The coefficient of correlation was 0.96 (P < 0.01) in obstructed unilateral uropathy and 0.92 (P < 0.01) in non-obstructed serie.
The differential renal function measured with DMSA and MAG-3 has a close correlation in congenital unilateral uropathies. Therefore in obstructed types, differential renal function and half-time elimination can be reliable and sure studied with MAG-3, being unnecessary DMSA test, avoiding additional radiation to the children.
在先天性梗阻性肾积水患者中,评估分肾功能(DRF)对于判断预后或确定手术治疗方案至关重要。测量分肾功能最可靠的方法是使用二巯基丁二酸(DMSA)进行同位素研究。虽然在第1至3分钟时,巯基乙酰三甘氨酸(MAG-3)也可测量分肾功能,但它主要用于评估肾脏排泄功能。
我们比较了用99Tc-二巯基丁二酸(DMSA)和99Tc-巯基乙酰三甘氨酸(MAG-3)方法评估先天性单侧尿路疾病患者分肾功能的情况。
我们回顾了138例先天性单侧尿路疾病儿童(年龄范围:0至9岁)的同位素研究结果:其中67例为梗阻性病例,71例为非梗阻性病例。所有患者均接受了DMSA和MAG-3的配对试验。两个系列均分为4组:1)DRF<40%,2)DRF 40 - 45%,3)DRF 46 - 50%和4)DRF>50%。分析了DMSA和MAG-3测量分肾功能的相关性。
在梗阻性单侧尿路疾病中,相关系数为0.96(P<0.01),在非梗阻性病例系列中为0.92(P<0.01)。
在先天性单侧尿路疾病中,用DMSA和MAG-3测量的分肾功能具有密切相关性。因此,在梗阻性类型中,使用MAG-3可以可靠且确定地研究分肾功能和半清除时间,无需进行DMSA检查,从而避免给儿童带来额外辐射。