Taghavi Rahim, Ariana Kamran, Arab Davoud
Department of Urology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Urol J. 2007 Winter;4(1):36-40.
The aim of this study was to evaluate diuresis renography with an intravenous injection of furosemide 20 minutes after administering the radiopharmaceutical (F+20 protocol) or 15 minutes before (F-15 protocol) in patients with upper urinary tract dilatation.
Twenty-one patients with pyelocaliceal system dilatation, but not ureteral dilatation, on ultrasonography were evaluated. The patients underwent diuresis renography using the F+20 and F-15 protocols. Renal scan findings and kidney split function were recorded. Then, the patients underwent surgical or conservative treatment according to their clinical conditions and imaging results. Follow-up was done 3 and 6 months postoperatively by physical examination, intravenous urography, and diuresis renography.
Eleven patients (52.4%) had complete obstruction in both protocols of renography, and 5 (23.8%) had an equivocal result in the F+20 and an obstructive pattern in the F-15. These patients underwent surgical operation. In 3 patients (14.3%), both protocols demonstrated a normal urinary tract. In 2 patients (9.5%), a nonobstructive response in the F+20 and an equivocal result in the F-15 were seen. One of them underwent surgical operation because of impaired kidney function during the follow-up and 1 was treated conservatively. Overall, obstruction was found in 16 out of 21 patients (76.2%) by the F-15 protocol, while it was found in 11 (52.4%) by the F+20 protocol (P=.01). The mean kidney split function was 55.15% +/- 7.82% and 54.81% +/- 6.87% in F+20 and F-15 protocols, respectively (P=.45).
Using the F-15 protocol may reduce the equivocal results of the F+20 for diuresis renography.
本研究的目的是评估在放射性药物给药后20分钟静脉注射呋塞米（F+20方案）或给药前15分钟（F-15方案）进行利尿肾图检查对尿路扩张患者的效果。
对21例超声检查显示肾盂肾盏系统扩张但输尿管未扩张的患者进行了评估。患者采用F+20和F-15方案进行利尿肾图检查。记录肾扫描结果和肾脏分肾功能。然后，根据患者的临床情况和影像学结果进行手术或保守治疗。术后3个月和6个月通过体格检查、静脉肾盂造影和利尿肾图检查进行随访。
11例患者（52.4%）在两种肾图检查方案中均显示完全梗阻，5例患者（23.8%）在F+20方案中结果不明确，在F-15方案中显示梗阻模式。这些患者接受了手术。3例患者（14.3%）在两种方案中均显示尿路正常。2例患者（9.5%）在F+20方案中显示无梗阻反应，在F-15方案中结果不明确。其中1例因随访期间肾功能受损接受了手术，1例接受了保守治疗。总体而言，F-15方案在21例患者中发现16例梗阻（76.2%），而F+20方案发现11例梗阻（52.4%）（P=0.01）。F+20和F-15方案中肾脏分肾功能的平均值分别为55.15%±7.82%和54.81%±6.87%（P=0.45）。
使用F-15方案可能会减少F+20利尿肾图检查结果不明确的情况。
