Roach P J, Paltiel H J, Perez-Atayde A, Tello R J, Davis R T, Treves S T
Department of Radiology, Children's Hospital, Boston, MA, USA.
Pediatr Radiol. 1995;25(6):472-5. doi: 10.1007/BF02019071.
Infantile renal dysplasias, including multicystic dysplastic kidneys (MCDK), are reported rarely to accumulate radiopharmaceuticals on renal scintigraphy. 99mTc DMSA is a highly sensitive tracer for detecting functioning renal cortical tissue and may be more suited to studying renal dysplasia than 99mTc DTPA. We reviewed the ultrasound studies and 99mTc DMSA scintigrams of 42 infants (age range 1-12 months) with known or suspected MCDK. Overall, uptake on 99mTc DMSA scintigraphy was evident in 6/41 (15%) dysplastic kidneys. Of the 18 patients who underwent nephrectomy, histopathological examination revealed that uptake correlated closely with the presence of mature renal cortical tissue in the affected kidney. Our study shows that a small, but significant number of MCDK will show low-grade uptake on DMSA scintigraphy. This finding may be relevant given the reliance placed on renal scintigraphy in planning treatment for infants with suspected MCDK, particularly with the increasing trend for the non-operative management of this condition.
婴儿期肾发育异常，包括多囊性发育不良肾（MCDK），在肾闪烁显像中很少有放射性药物蓄积的报道。99mTc DMSA是检测功能性肾皮质组织的高灵敏度示踪剂，可能比99mTc DTPA更适合用于研究肾发育异常。我们回顾了42例已知或疑似患有MCDK的婴儿（年龄范围1至12个月）的超声检查和99mTc DMSA闪烁显像结果。总体而言，41例发育异常肾中，有6例（15%）在99mTc DMSA闪烁显像中有明显摄取。在接受肾切除术的18例患者中，组织病理学检查显示摄取情况与患肾中成熟肾皮质组织的存在密切相关。我们的研究表明，一小部分但数量可观的MCDK在DMSA闪烁显像中会显示低度摄取。鉴于在为疑似MCDK的婴儿制定治疗方案时对肾闪烁显像的依赖，尤其是考虑到对这种疾病采取非手术治疗的趋势日益增加，这一发现可能具有重要意义。
