Holten I, Storm H H
Scand J Urol Nephrol. 1979;13(3):275-81. doi: 10.3109/00365597909179537.
43 patients underwent an extended scintigraphic procedure with 99mTc-dimercaptosuccinylic acid in order to investigate its proper use for diagnosing morphological and functional kidney abnormalities. The group was comprised of patients without renal disease, and patients with diffuse parenchymal disease, obstructive uropathy, renal cysts and renal tumors. The study was followed by 131I-hippurate renography. We propose a simplified routine procedure with scintiphotos taken 10-15 min after injection for topographic information and 120 min after injection for renal morphology. This procedure allows excellent case finding of diffuse parenchymal disease of a special value in cases of radiological non-visualization. The technique is indicated, when iodine contrast media cannot be used for radiological examinations. DMSA studies, however, do not allow safe functional evaluation in all categories of patients. Neither can obstructive nephropathy be diagnosed unless the renal pelvis is dilated. Renal perfusion studies are contaminated by the perfusion of liver and spleen. Nevertheless, a tentative differentiation between cysts and tumours is possible, the former being hypoperfused the latter hyperperfused. When supplemented with gamma camera 131I-hippurate renography, the total scintigraphic procedure will also include split function determination and run-off evaluation.
43例患者接受了用99mTc-二巯基丁二酸进行的扩展闪烁扫描检查，以研究其在诊断肾脏形态和功能异常方面的合理应用。该组包括无肾脏疾病的患者，以及患有弥漫性实质性疾病、梗阻性尿路病、肾囊肿和肾肿瘤的患者。该研究之后进行了131I-马尿酸盐肾图检查。我们提出一种简化的常规程序，在注射后10 - 15分钟拍摄闪烁照片以获取地形信息，在注射后120分钟拍摄以观察肾脏形态。该程序能很好地发现弥漫性实质性疾病，在放射学检查未显影的情况下具有特殊价值。当碘造影剂不能用于放射学检查时，可采用该技术。然而，二巯基丁二酸研究并不能对所有类型的患者进行安全的功能评估。除非肾盂扩张，否则梗阻性肾病也无法诊断。肾脏灌注研究受到肝脏和脾脏灌注的影响。尽管如此，囊肿和肿瘤之间仍有可能进行初步区分，前者灌注不足，后者灌注过度。当补充γ相机131I-马尿酸盐肾图检查时，整个闪烁扫描程序还将包括分肾功能测定和排泄评估。
