肾动脉血运重建术可恢复无放射性示踪剂摄取的肾功能。
Renal artery revascularisation can restore kidney function with absent radiotracer uptake.
机构信息
Department of Nephrology, Great Ormond Street Hospital for Children, NHS Trust, Great Ormond Street, London, WC1N 3JH, UK.
Department of Vascular Surgery, Royal Free Hospital, London, UK.
出版信息
Pediatr Nephrol. 2012 Nov;27(11):2153-2157. doi: 10.1007/s00467-012-2235-4. Epub 2012 Jun 29.
BACKGROUND
Children with renovascular hypertension often present with severe hypertension. Some children have severe obstruction of their renal arteries resulting in <10% relative function on [(99m)Tc]dimercaptosuccinic acid (DMSA) scan. Conventional treatment of these children has been nephrectomy of the poorly functioning kidney to normalise their blood pressure (BP).
CASE-DIAGNOSIS/TREATMENT: We describe three children aged 20 months to 9 years with severe renal artery stenosis and severe hypertension who had radionucleotide uptake of 0% in one kidney. In one case, no renal perfusion was demonstrated by duplex ultrasound scan. Significant recovery of relative renal function of 18 to 52% was achieved after revascularisation by percutaneous angioplasty or open surgery of the obstructed renal artery.
CONCLUSION
These cases illustrate that scintigraphy alone cannot be used to predict salvageable function in children with renovascular disease.
背景
患有肾血管性高血压的儿童常表现为严重的高血压。一些儿童的肾动脉严重阻塞，导致 [(99m)Tc]二巯丁二酸 (DMSA) 扫描的相对功能<10%。这些儿童的常规治疗方法是切除功能不佳的肾脏以使其血压 (BP) 正常化。
病例诊断/治疗：我们描述了 3 名年龄为 20 个月至 9 岁的儿童，他们患有严重的肾动脉狭窄和严重的高血压，其中一侧肾脏的放射性核素摄取率为 0%。在一个病例中，双功能超声扫描未显示肾灌注。经皮血管成形术或阻塞性肾动脉开放性手术血管重建后，相对肾功能显著恢复 18%至 52%。
结论
这些病例表明，单独的闪烁扫描不能用于预测患有肾血管疾病的儿童中可挽救的功能。
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