Ruiz-Martínez A, Sierra-Díaz E, Celis-de la Rosa A J, Valenzuela Hernández M Á, González Flores M G, Belmonte Hernández M V
Departamento de Cirugía Pediátrica, Hospital general de Zona 67, Instituto Mexicano del Seguro Social (IMSS), Apodaca, Nuevo León, México.
Departamento de Urología, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Jalisco, México.
Actas Urol Esp (Engl Ed). 2019 Oct;43(8):419-424. doi: 10.1016/j.acuro.2019.02.005. Epub 2019 Jun 1.
A cross-sectional study was carried out with the objective of evaluating the usefulness of Doppler ultrasound with resistive index (RI) measure compared with renal scintigraphy with Tc-DTPA in children with unilateral ureteropelvic junction obstruction.
The study included children under 15 years with a diagnosis of unilateral ureteropelvic junction obstruction, healthy contralateral kidney with or without an antecedent of ureteropyeloplasty. The selected patients were sent to the Nuclear Medicine Department to carry out a renal scintigraphy with Tc-DTPA and days later were sent to the Radiology Department for the performance of Renal Doppler Ultrasound with RI.
A total of 21 patients were included in the study, 15 males and 6 females, representing 71.4% and 28.6%, respectively. Mean age was 5.3 years. Only 3 had an antecedent of ureteropyeloplasty in the affected kidney. The scintigraphy reported data of unilateral obstruction in 18 patients, including the 3 patients with previous surgery. The average glomerular filtration rate (GFR) obtained with the scintigraphy was 100.28ml/min. The average GFR in affected kidneys was 43.03ml/min and 57.24ml/min in healthy kidneys (p<.001). Doppler ultrasound with RI reported ectasia in 100% of the affected kidneys and one normal contralateral kidney. The average RI in affected kidneys was 0.69mm/s and 0.50mm/s in healthy kidneys (p<.001).
With the results obtained, we can suggest that ultrasound Doppler with measurement of RI can be an alternative tool to renal scintigraphy with Tc-DTPA in some cases.
开展一项横断面研究，旨在评估与采用Tc-DTPA进行肾闪烁扫描术相比，具有阻力指数（RI）测量功能的多普勒超声对单侧输尿管肾盂连接部梗阻患儿的应用价值。
该研究纳入了15岁以下诊断为单侧输尿管肾盂连接部梗阻的患儿，其对侧肾脏健康，有或无前输尿管肾盂成形术史。所选患者被送往核医学科进行Tc-DTPA肾闪烁扫描术，数日后被送往放射科进行带RI的肾多普勒超声检查。
该研究共纳入21例患者，其中男性15例，女性6例，分别占71.4%和28.6%。平均年龄为5.3岁。仅3例患侧肾脏有输尿管肾盂成形术史。闪烁扫描术报告18例患者存在单侧梗阻数据，包括3例曾接受手术的患者。闪烁扫描术测得的平均肾小球滤过率（GFR）为100.28ml/分钟。患侧肾脏的平均GFR为43.03ml/分钟，健侧肾脏为57.24ml/分钟（p<0.001）。带RI的多普勒超声报告100%的患侧肾脏有扩张，对侧肾脏正常。患侧肾脏的平均RI为0.69mm/秒，健侧肾脏为0.50mm/秒（p<0.001）。
根据所获结果，我们可以提出，在某些情况下，带RI测量功能的超声多普勒可作为Tc-DTPA肾闪烁扫描术的替代工具。
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