Kubota K, Atkins H L, Anaise D, Oster Z H, Pollack W
Department of Radiology, State University of New York, Stony Brook 11794-8460.
Clin Nucl Med. 1989 Jan;14(1):8-12. doi: 10.1097/00003072-198901000-00003.
In order to evaluate the renal excretion quantitatively, the authors analyzed the Tc-99m DTPA renogram using mean transit time (MTT) with deconvolution analysis and compared it to the perfusion index. One hundred thirteen studies consisting of 25 normal, 11 obstruction, 35 transplant-norm, 12 transplant-obstruction, and 30 transplant-rejection were evaluated. In the non-transplant obstruction, MTT is significantly long (3.40 +/- 0.85 minutes vs 2.02 +/- 0.42 minutes) and has high sensitivity (100%) and specificity (93%, 23/25) for the diagnosis of obstruction. In the transplant-obstruction, if the field of view includes both transplant and liver or spleen as a blood pool image, MTT has high sensitivity for the diagnosis (10/11) and for the follow up of obstruction (12/12), with the same specificity, but low sensitivity for rejection (25%). Perfusion index is of value in the diagnosis of rejection (73% specificity, 77% sensitivity) but is useless for the detection of obstruction (25% specificity, 75% sensitivity). The authors conclude that MTT is a useful marker for diagnosis and serial quantitative evaluation of renal obstruction. Also, they suggest the use of multiple techniques based on different principles for the complete evaluation of the renal scan.
为了定量评估肾脏排泄功能，作者使用去卷积分析的平均通过时间（MTT）对锝-99m二乙三胺五乙酸（Tc-99m DTPA）肾图进行分析，并将其与灌注指数进行比较。对113项研究进行了评估，其中包括25例正常、11例梗阻、35例移植肾功能正常、12例移植肾梗阻和30例移植肾排斥反应。在非移植肾梗阻中，MTT明显延长（3.40±0.85分钟对2.02±0.42分钟），对梗阻诊断具有高敏感性（100%）和特异性（93%，23/25）。在移植肾梗阻中，如果视野包括移植肾以及作为血池图像的肝脏或脾脏，MTT对梗阻诊断（10/11）和随访（12/12）具有高敏感性，特异性相同，但对排斥反应的敏感性较低（25%）。灌注指数在排斥反应诊断中具有价值（特异性73%，敏感性77%），但对梗阻检测无作用（特异性25%，敏感性75%）。作者得出结论，MTT是诊断和连续定量评估肾梗阻的有用标志物。此外，他们建议基于不同原理使用多种技术来全面评估肾脏扫描。
