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[新生儿肾积水:出生后第一个月使用锝99m巯基乙酰三甘氨酸进行动态肾闪烁显像]

[Newborn hydronephrosis: dynamic renal scintigraphy with Tc99m MAG3 in the first month of life].

作者信息

Orellana Pilar, Baquedano Paulina, Cavagnaro Felipe, Lagomarsino Edda, García Cristián, Carreño Juan Eduardo, Meneses Luis

机构信息

Departamentos de Radiología, Pediatría, Urología, Laboratorio de Medicina Nuclear, Hospital Clínico, Facultad de Medicina, Pontificia Universidad Católica de Chile.

出版信息

Rev Med Chil. 2003 Mar;131(3):251-8.

Abstract

BACKGROUND

The early and accurate diagnosis of obstructive uropathy in the newborn, prevents secondary complications and kidney damage.

AIM

To study the usefulness of Tc99M MAG3 diuretic renogram in newborns with hydronephrosis.

MATERIAL AND METHODS

Forty newborns, aged 1 to 30 days, with hydronephrosis, were studied. A Tc99M MAG3 diuretic renogram (DR) was done and its results were compared with clinical features and other imaging studies. Each kidney and its ureter, were considered a renal unit.

RESULTS

Seventy six renal units were evaluated. Twenty six were normal on prenatal ultrasound examination and DR. In 11 of the 50 renal units with hydronephrosis, renal function was impaired. Thus, it was impossible to obtain an excretory curve. In 17 of the 39 remaining renal units, the absence of obstructive uropathy was demonstrated clinically. In 16 of these, the DR showed absence of obstruction. In 20 of 21 renal units with confirmed obstructive uropathy, DR showed an obstructive pattern.

CONCLUSIONS

In newborns, there is an adequate Tc99M MAG3 uptake and diuretic response. Thus, DR becomes a good functional assessment method in newborns with hydronephrosis.

摘要

背景

新生儿梗阻性肾病的早期准确诊断可预防继发性并发症和肾损伤。

目的

研究Tc99M 巯基乙酰三甘氨酸利尿肾图在新生儿肾积水诊断中的应用价值。

材料与方法

对40例年龄在1至30天的新生儿肾积水患者进行研究。进行了Tc99M 巯基乙酰三甘氨酸利尿肾图(DR)检查,并将其结果与临床特征及其他影像学检查结果进行比较。每个肾脏及其输尿管被视为一个肾单位。

结果

共评估了76个肾单位。26个在产前超声检查和DR检查中显示正常。在50个肾积水肾单位中,有11个肾功能受损,因此无法获得排泄曲线。在其余39个肾单位中的17个,临床上显示无梗阻性肾病。其中16个,DR显示无梗阻。在21个确诊为梗阻性肾病的肾单位中的20个,DR显示为梗阻性图形。

结论

在新生儿中,Tc99M 巯基乙酰三甘氨酸摄取和利尿反应良好。因此,DR成为新生儿肾积水的一种良好的功能评估方法。

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