Arlart I, Rosenthal J, Adam W E, Bargon G, Franz H E
Cardiovasc Radiol. 1979 Apr 27;2(2):115-25. doi: 10.1007/BF02575372.
The validity of noninvasive (iodine-131 iodohippurate renogram, iodine-131 ortho-iodohippurate clearance, indium-113m EDTA--technetium-99m DTPA sequential renal scan) and invasive (xenon-133 washout) radionuclide screening tests was evaluated in the diagnosis of 105 patients with unilateral renovascular hypertension (RVH) and in 45 patients with essential hypertension (EH). In RVH positive findings on the stenosed side were noted in 73% of renograms, 73% of o-iodohippurate-clearance tests (N = 22), 81% of sequential renal scans, and 90% of xenon-washout studies (N = 67). In a subgroup of 55 retrospectively selected patients with normal or improved blood pressure following renovascular surgery, the preoperative findings had been positive on the stenosed side in 78% of renograms, 75% of o-iodohippurate-clearance tests (n = 20), 85% of sequential renal scans, and 93% of xenon-washout studies (n = 23). The sequential renal scan appears to be a sufficiently reliable method in noninvasive screening for unilateral RVH, although invasive xenon-washout studies show a higher percentage of hemodynamic alterations in the stenosed kidney. o-iodohippurate clearance tests, and in particular xenon-washout studies, can reveal arteriosclerotic lesions in the contralateral, non-stenosed kidney, which may be of importance when the decision for renovascular surgery is pending.
在对105例单侧肾血管性高血压（RVH）患者和45例原发性高血压（EH）患者的诊断中，评估了非侵入性（碘-131碘马尿酸肾图、碘-131邻碘马尿酸清除率、铟-113m乙二胺四乙酸-锝-99m二乙三胺五乙酸序贯肾扫描）和侵入性（氙-133洗脱）放射性核素筛查试验的有效性。在RVH患者中，狭窄侧肾图阳性结果占73%，邻碘马尿酸清除率试验阳性结果占73%（N = 22），序贯肾扫描阳性结果占81%，氙洗脱研究阳性结果占90%（N = 67）。在55例经回顾性选择的肾血管手术后血压正常或改善的患者亚组中，术前狭窄侧肾图阳性结果占78%，邻碘马尿酸清除率试验阳性结果占75%（n = 20），序贯肾扫描阳性结果占85%，氙洗脱研究阳性结果占93%（n = 23）。序贯肾扫描似乎是一种在非侵入性筛查单侧RVH中足够可靠的方法，尽管侵入性氙洗脱研究显示狭窄肾脏中血流动力学改变的百分比更高。邻碘马尿酸清除率试验，尤其是氙洗脱研究，可以揭示对侧非狭窄肾脏的动脉硬化病变，这在决定是否进行肾血管手术时尚未确定时可能很重要。
