Department of Nuclear Medicine, Cristo Re Hospital, Rome, Italy.
Clin Nucl Med. 2013 Jun;38(6):432-6. doi: 10.1097/RLU.0b013e31828da3f5.
The objective of this study was to compare 2 diuretic renography procedures: F-15 versus F+10(sp) for diagnosis of obstructive uropathy in adults.
Thirty-six patients with unilateral or bilateral hydronephrosis had 2 consecutive Tc-MAG3 diuretic renograms within 7 days, using the widely used procedure F-15 in supine position, and a new seated-position procedure whereby the patient drinks 400 to 500 mL of water at 5 minutes and receives an injection of 20 mg of furosemide at 10 minutes [F+10 (sp)].
F-15 showed nonobstructive results in 63.9% of kidneys, obstruction in 26.4%, and equivocal findings in 6.9% and was not applicable in 2.8%. F+10(sp) showed nonobstructive results in 70.9%, obstruction in 27.8%, and equivocal result in 1.4% of kidneys. Nephroptosis was observed by F+10(sp) in 22.2% of kidneys. Adverse effects reported for the F-15 were hypotension in 2 patients, renal colic in 3 patients, and interruption due to voiding in 5 patients. No adverse effects were reported for F+10(sp).
This study shows that the F+10(sp) procedure reduces the equivocal findings of F-15 procedure in 36 patients. It can improve the accuracy and compliance, avoiding adverse effects and reducing bladder filling-related problems.
本研究旨在比较两种利尿肾图检查程序:F-15 与 F+10(sp)在成人梗阻性尿路病诊断中的应用。
36 例单侧或双侧肾积水患者在 7 天内连续进行 2 次 Tc-MAG3 利尿肾图检查,采用广泛应用的仰卧位 F-15 程序和新的坐位程序,患者在 5 分钟时饮用 400 至 500 毫升水,并在 10 分钟时注射 20 毫克呋塞米[F+10(sp)]。
F-15 显示 63.9%的肾脏无梗阻,26.4%的肾脏有梗阻,6.9%的肾脏结果不确定,2.8%的肾脏不适用于该程序。F+10(sp)显示 70.9%的肾脏无梗阻,27.8%的肾脏有梗阻,1.4%的肾脏结果不确定。F+10(sp)观察到 22.2%的肾脏存在肾下垂。F-15 报告的不良反应有 2 例低血压,3 例肾绞痛,5 例因排尿中断。F+10(sp)未报告不良反应。
本研究表明,F+10(sp)程序减少了 36 例患者中 F-15 程序的不确定结果。它可以提高准确性和顺应性,避免不良反应,并减少与膀胱充盈相关的问题。