Flueckiger F, Fueger G F, Hausegger K, Nicoletti R, Pogglitsch H
Department of Radiology, Karl-Franzens-University, Graz, Austria.
Nucl Med Commun. 1989 Nov;10(11):795-806. doi: 10.1097/00006231-198911000-00004.
The results of computer-assisted static and dynamic renal scintigraphy in 57 patients with renovascular hypertension (RVH) and 23 patients with essential hypertension (EH) are presented. The following parameters were quantified: renal size (RS), count density (CD), relative unilateral renal clearance (RRC), mean parenchymal transit time (PTT), difference of time-to-peak of activity (tmaxd) to stenosed minus non-stenosed side, effect of frusemide (FE) and renal parenchymal radionuclide retention (RI). Among 57 stenosed renal arteries we detected 54 (true-positive cases) and missed three (false-negative cases); among 23 patients with EH and no significant haemodynamic renal artery stenosis, we found 21 cases correctly negative and two patients falsely positive. These data yielded a sensitivity of 95% and a specificity of 92%. The quantification of renal radionuclide studies in renal artery stenoses minimizes false-positive results and increases their specificity. This study shows that, because of its sensitivity, quantitative renal scintigraphy reliably allows the assessment of the functional haemodynamic effects of a renovascular lesion (significant stenosis) in the diagnostic work-up and during follow-up after surgical reconstruction or percutaneous transluminal angioplasty (PTA). The evaluation of renal function is in general greatly supported by the quantitative parameters, yet particularly after medication with converting enzyme inhibitors and after intervention.
本文展示了57例肾血管性高血压（RVH）患者和23例原发性高血压（EH）患者的计算机辅助静态和动态肾闪烁扫描结果。对以下参数进行了量化：肾脏大小（RS）、计数密度（CD）、相对单侧肾脏清除率（RRC）、平均实质转运时间（PTT）、狭窄侧与非狭窄侧的峰值时间差（tmaxd）、速尿的作用（FE）以及肾实质放射性核素滞留（RI）。在57条狭窄肾动脉中，我们检测出54条（真阳性病例），漏诊3条（假阴性病例）；在23例无明显血流动力学肾动脉狭窄的EH患者中，我们正确判断出21例为阴性，2例为假阳性。这些数据得出的敏感性为95%，特异性为92%。肾动脉狭窄的肾放射性核素研究量化可减少假阳性结果并提高其特异性。本研究表明，由于其敏感性，定量肾闪烁扫描在诊断检查以及手术重建或经皮腔内血管成形术（PTA）后的随访期间，能够可靠地评估肾血管病变（明显狭窄）的功能性血流动力学效应。一般来说，定量参数极大地支持了肾功能评估，尤其是在使用转换酶抑制剂治疗后以及干预后。
