From the *Department of Nuclear Medicine, †Division of Nephrology, Department of Internal Medicine, and ‡Department of Diagnostic Radiology, Ege University Medical Faculty; and §Department of Pathology, Ataturk Education and Research Hospital, Katip Celebi University, Izmir, Turkey.
Clin Nucl Med. 2015 Jul;40(7):548-52. doi: 10.1097/RLU.0000000000000789.
Value of renal transplant scintigraphy and resistance index (RI) in the assessment of renal graft function is well known. The aim of this study was to evaluate the predictive value of renal transplant scintigraphy and RI for long-term graft function.
A total of 119 patients were analyzed retrospectively. Renal transplant scintigraphy with technetium Tc 99 m DTPA and color Doppler ultrasonography for RI were performed to each patient within 2 days after transplantation. Resistance index and the results of the tests in perfusion/renographic curve analysis of scintigraphy were compared with the serum creatinine (sCr) levels at 3 months, 1 year, and 5 years after transplantation. A sCr level of more than 1.5 mg/dL was considered abnormal.
Differences of the mean values of T½ of graft washout (GW½), time difference between peak renal perfusion and arterial count ([INCREMENT]P), and accumulation index (R20/3) were significantly high in patients with high follow-up sCr (>1.5 mg/dL) (P < 0.01). The correlation of these tests with the follow-up sCr levels was significant (P < 0.01). The number of recipients with high perfusion curve grade was also significant in the follow-up groups with high sCr levels. However, difference of the mean value of RI was insignificant between the follow-up groups, and there was no correlation between the RI and sCr levels.
Renal transplant scintigraphy performed within 2 days after transplantation is useful in the prediction of long-term graft function at 3 months, 1 year, and 5 years; and it is superior to resistance index.
肾移植闪烁显像和阻力指数(RI)在评估移植肾功能中的价值是众所周知的。本研究的目的是评估肾移植闪烁显像和 RI 对长期移植物功能的预测价值。
回顾性分析了 119 例患者。在移植后 2 天内对每位患者进行肾移植闪烁显像(用锝 99m DTPA)和彩色多普勒超声检查 RI。将 RI 与闪烁显像灌注/肾图分析中的结果与移植后 3 个月、1 年和 5 年的血清肌酐(sCr)水平进行比较。sCr 水平超过 1.5mg/dL 被认为异常。
在 sCr 水平高的患者(>1.5mg/dL)中,洗脱半衰期(GW½)、峰值肾灌注与动脉计数之间的时间差([INCREMENT]P)和积累指数(R20/3)的平均值差异显著较高(P<0.01)。这些测试与随访 sCr 水平之间的相关性具有统计学意义(P<0.01)。在 sCr 水平高的随访组中,高灌注曲线分级的受者数量也显著增加。然而,RI 的平均值差异在 sCr 水平的随访组之间不显著,RI 与 sCr 水平之间也没有相关性。
在移植后 2 天内进行的肾移植闪烁显像对于预测 3 个月、1 年和 5 年的长期移植物功能是有用的,优于 RI。