Aguiar Pablo, Pérez-Fentes Daniel, Garrido Miguel, García Camilo, Ruibal Álvaro, Cortés Julia
Nuclear Medicine Department, Clinical Hospital, Santiago de Compostela, Spain -
Q J Nucl Med Mol Imaging. 2016 Jun;60(2):154-62.
The aim of this study was to develop a method for estimating DMSA SPECT renal function on each renal pole in order to evaluate the effect of percutaneous nephrolithotripsy by focusing the measurements on the region through which the percutaneous approach is performed.
Twenty patients undergoing percutaneous nephrolithotripsy between November 2010 and June 2012 were included in this study. Both Planar and SPECT-DMSA studies were carried out before and after nephrolithotripsy. The effect of percutaneous nephrolithotripsy was evaluated by estimating the total renal function and the regional renal function of each renal pole. Despite PCNL has been previously reported as a minimally invasive technique, our results showed regional renal function decreases in the treated pole in most patients, affecting the total renal function in a few of them.
A quantification method was used for estimating the SPECT DMSA renal function of the upper, interpolar and lower renal poles. Our results confirmed that total renal function was preserved after nephrolithotripsy. Nevertheless, the proposed method showed that the regional renal function of the treated pole decreased in most patients (15 of 20 patients), allowing us to find differences in patients who had not shown changes in the total renal function obtained from conventional quantification methods.
A method for estimating the SPECT DMSA renal function focused on the treated pole enabled us to show for the first time that nephrolithotripsy can lead to a renal parenchymal damage restricted to the treated pole.
本研究的目的是开发一种方法，用于估计每个肾极的二巯基丁二酸（DMSA）单光子发射计算机断层扫描（SPECT）肾功能，以便通过将测量重点放在经皮穿刺路径所在区域来评估经皮肾镜取石术的效果。
本研究纳入了2010年11月至2012年6月期间接受经皮肾镜取石术的20例患者。在经皮肾镜取石术前和术后均进行了平面和SPECT-DMSA检查。通过估计总肾功能和每个肾极的区域肾功能来评估经皮肾镜取石术的效果。尽管先前已报道经皮肾镜取石术是一种微创技术，但我们的结果显示，大多数患者治疗侧肾极的区域肾功能下降，少数患者的总肾功能也受到影响。
采用一种定量方法来估计上、极间和下肾极的SPECT DMSA肾功能。我们的结果证实，经皮肾镜取石术后总肾功能得以保留。然而，所提出的方法显示，大多数患者（20例中的15例）治疗侧肾极的区域肾功能下降，这使我们能够在那些常规定量方法显示总肾功能无变化 的患者中发现差异。
一种聚焦于治疗侧肾极的SPECT DMSA肾功能估计方法使我们首次表明，经皮肾镜取石术可导致仅局限于治疗侧肾极的肾实质损伤。
