From the *University of Belgrade - Faculty of Medicine; †Center for Nuclear Medicine, Clinical Center of Serbia; and ‡University of Belgrade - Faculty of Electrical Engineering, Belgrade, Serbia.
Clin Nucl Med. 2014 Jul;39(7):598-604. doi: 10.1097/RLU.0000000000000470.
The objectives of the study were to use the International Atomic Energy Agency (IAEA) software package for the analysis of scintigraphic renal dynamic studies to obtain values of curve parameters and excretory parameters in children with hydronephrosis and to validate the reliability of these numerical outputs by comparing with values established by consensus reports.
Fifty children with hydronephrosis (median age, 16 months; 30 boys, 20 girls; 99 kidneys) underwent Tc-MAG3 diuresis renography. Studies were analyzed by 2 observers, and according to the assessment of images, renograms, and differential function, kidneys were classified as normal (42, kidneys contralateral to hydronephrotic kidney), hypotonic unobstructed (49), and obstructed (8). The IAEA software was applied to each renogram. The parameters analyzed were as follows: normalized residual activity at 20 minutes (NORA 20) and on postmicturition (PM) acquisition, output efficiency at 20 minute (OE 20), PM to maximum renal count ratio (PM/max), and mean transit time (MTT).
Mean values for normal, hypotonic unobstructed, and obstructed kidneys were as follows: NORA 20: 0.25, 0.57, and 2.16; OE 20 (%): 94.5, 87, and 57; normalized residual activity on PM acquisition: 0.02, 0.03, and 0.27; PM/max: 0.01, 0.02, and 0.13; and MTT (minutes): 1.9, 3.5, and 8.9, respectively. Difference between obstruction/dilatation and normal/dilatation was significant (P < 0.0001), as well as the correlation between NORA 20/OE 20 (R = -0.982). Cutoff values to predict obstruction were as follows: NORA 20, 1.6; OE 20, 73%; NORA PM, 0.11; PM/max, 0.06; and MTT, 8.23 minutes.
The IAEA software package gives reliable values of numerical parameters of renal excretion. The use of the software improves diagnostic accuracy of diuresis renography in children.
本研究的目的是使用国际原子能机构（IAEA）的软件包分析闪烁照相肾动态研究，以获取患有肾积水的儿童的曲线参数和排泄参数值，并通过与共识报告中确定的值进行比较来验证这些数值输出的可靠性。
50 名患有肾积水的儿童（中位年龄 16 个月；男 30 名，女 20 名；99 个肾脏）接受了 Tc-MAG3 利尿剂肾图检查。研究由 2 名观察者进行分析，根据图像、肾图和功能差异评估，将肾脏分为正常（42 个，对侧肾积水的肾脏）、低张力无梗阻（49 个）和梗阻（8 个）。IAEA 软件应用于每个肾图。分析的参数如下：20 分钟时的归一化残留活性（NORA 20）和排尿后（PM）采集时的残留活性、20 分钟时的输出效率（OE 20）、PM 与最大肾计数比（PM/max）和平均通过时间（MTT）。
正常、低张力无梗阻和梗阻肾脏的平均值如下：NORA 20：0.25、0.57 和 2.16；OE 20（%）：94.5、87 和 57；PM 采集时的归一化残留活性：0.02、0.03 和 0.27；PM/max：0.01、0.02 和 0.13；MTT（分钟）：1.9、3.5 和 8.9。梗阻/扩张与正常/扩张之间的差异具有统计学意义（P < 0.0001），并且 NORA 20/OE 20 之间存在相关性（R = -0.982）。预测梗阻的截断值如下：NORA 20，1.6；OE 20，73%；NORA PM，0.11；PM/max，0.06；MTT，8.23 分钟。
IAEA 软件包提供了可靠的肾排泄数值参数值。该软件的使用提高了儿童利尿肾图的诊断准确性。
