Siripongsatian Dheeratama, Tewattanarat Nipaporn, Wongsurawat Nantaporn, Wisanuyotin Suwannee, Theerakulpisut Daris
Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kean, Thailand.
National Cyclotron and PET Centre, Chulabhorn Hospital, Bangkok, Thailand.
PLoS One. 2025 May 19;20(5):e0324446. doi: 10.1371/journal.pone.0324446. eCollection 2025.
Diuretic renal scintigraphy (DRS) is a valuable imaging tool for distinguishing obstructive from non-obstructive hydronephrosis, especially in pediatric patients, but non-diagnostic results are not uncommon. In this retrospective analytical study, we examined if kidney ultrasound (US) parameters can predict non-diagnostic DRS, and DRS with an obstruction pattern, potentially guiding patient selection to reduce unnecessary radiation exposure. The study included 67 patients (134 kidneys), 1-month to 4-years of age who underwent both DRS and US. Receiver operating characteristic (ROC) curve analysis of US parameters including parenchymal thickness, cortical thickness, medullary pyramidal thickness, anterior-posterior renal pelvic diameter, was done to assess the predictiveness of these parameters for prediction of DRS results. None of the US parameters reliably predicted non-diagnostic DRS results (AUC range: 0.41-0.61). However, these parameters demonstrated good predictiveness for identifying DRS with an obstruction pattern (AUC range: 0.69-0.87), with anterior-posterior renal pelvic diameter showing the highest performance. These findings suggest that while US parameters cannot predict non-diagnostic DRS outcomes, they are effective in identifying obstruction patterns on DRS.
利尿肾动态显像（DRS）是区分梗阻性与非梗阻性肾积水的一种有价值的影像学工具，尤其在儿科患者中，但非诊断性结果并不少见。在这项回顾性分析研究中，我们研究了肾脏超声（US）参数是否能够预测非诊断性DRS以及具有梗阻模式的DRS，这可能有助于指导患者选择，以减少不必要的辐射暴露。该研究纳入了67例年龄在1个月至4岁之间、同时接受了DRS和US检查的患者（134个肾脏）。对包括实质厚度、皮质厚度、髓质锥体厚度、肾盂前后径在内的US参数进行了受试者操作特征（ROC）曲线分析，以评估这些参数对DRS结果预测的预测性。没有一个US参数能够可靠地预测非诊断性DRS结果（AUC范围：0.41 - 0.61）。然而，这些参数在识别具有梗阻模式的DRS方面表现出良好的预测性（AUC范围：0.69 - 0.87），其中肾盂前后径的表现最佳。这些发现表明，虽然US参数不能预测非诊断性DRS结果，但它们在识别DRS上的梗阻模式方面是有效的。
