Yu Seong Hyeon, Kang Taek Won, Park Chan, Cho Sang-Geon
Department of Urology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju 61469, Republic of Korea.
Department of Radiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju 61469, Republic of Korea.
J Clin Med. 2025 Sep 5;14(17):6276. doi: 10.3390/jcm14176276.
: This prospective study aimed to assess residual cortical function at follow-up in patients with traumatic renal injuries using Tc-99m dimercaptosuccinic acid (DMSA) single-photon emission computed tomography (SPECT) and evaluate clinical factors associated with residual cortical function. : A total of 59 patients with renal injury who were treated non-operatively and underwent Tc-99m DMSA SPECT at the follow-up (3 months ± 1 year) were enrolled. The correlation between residual cortical function and renal injury grades, alongside other clinical factors, was analysed. : The mean age of the patients was 49.10 ± 22.67 years, and 35 (59.3%) were male. In total, 28 patients (47.5%) had high-grade injuries, and 20 (33.9%) underwent a renal artery endovascular procedure (RAE). High-grade renal injury correlated with laboratory renal function and DMSA scintigraphic parameters, especially SPECT split renal function (SRF) (ρ = -0.565; < 0.001); meanwhile, a significant decrease existed in DMSA scintigraphic parameters in patients with high-grade injuries. Furthermore, laboratory renal function and DMSA scintigraphic parameters were significantly decreased in patients who underwent RAE. The multivariable analysis highlighted that high grade renal injury (odds ratio [OR], 9.50; 95% confidence interval (CI), 1.78-50.61; = 0.008) and RAE (OR, 5.15; 95% CI, 1.07-24.88; = 0.041) were significant factors associated with decreased residual cortical function. Tc-99m DMSA SPECT provides accurate information on the residual cortical function at follow-up in patients with renal injuries. Additionally, high-grade renal injury and RAE were associated with decreased residual cortical function.
本前瞻性研究旨在使用锝-99m二巯基丁二酸（DMSA）单光子发射计算机断层扫描（SPECT）评估创伤性肾损伤患者随访时的残余皮质功能，并评估与残余皮质功能相关的临床因素。共纳入59例非手术治疗的肾损伤患者，这些患者在随访（3个月±1年）时接受了锝-99m DMSA SPECT检查。分析了残余皮质功能与肾损伤分级以及其他临床因素之间的相关性。患者的平均年龄为49.10±22.67岁，其中35例（59.3%）为男性。共有28例患者（47.5%）为重度损伤，20例（33.9%）接受了肾动脉血管内介入治疗（RAE）。重度肾损伤与实验室肾功能及DMSA闪烁显像参数相关，尤其是SPECT分肾功能（SRF）（ρ=-0.565；P<0.001）；同时，重度损伤患者的DMSA闪烁显像参数显著降低。此外，接受RAE的患者其实验室肾功能和DMSA闪烁显像参数也显著降低。多变量分析强调，重度肾损伤（比值比[OR]，9.50；95%置信区间[CI]，1.78-50.61；P=0.008）和RAE（OR，5.15；95%CI，1.07-24.88；P=0.041）是与残余皮质功能降低相关的重要因素。锝-99m DMSA SPECT为肾损伤患者随访时的残余皮质功能提供了准确信息。此外，重度肾损伤和RAE与残余皮质功能降低有关。
