Groshar D, Issaq E, Nativ O, Livne P M
Department of Nuclear Medicine, Bnai Zion Medical Center, Haifa, Israel.
J Urol. 1996 Mar;155(3):844-6. doi: 10.1016/s0022-5347(01)66322-5.
We evaluated whether increased differential renal function on the pentetic acid (DTPA) renogram represents elevated renal function in obstructed kidneys.
In 10 patients with unilateral ureteropelvic junction obstruction and a differential function of 53% or greater on the DTPA renogram of the obstructed kidney we performed quantitative single photon emission computerized tomography of dimercapto-succinic acid uptake by the kidneys.
The absolute uptake of dimercapto-succinic acid was significantly higher in the obstructed kidneys compared to the contralateral normal kidneys (30.0% +/- 7.8 versus 25.3% +/- 8.2, t = 3.6, p < 0.01, respectively). The elevated absolute uptake in the obstructed kidneys was due to an increased functional volume compared to the contralateral normal kidneys (126.0 +/- 69.7 cc versus 102.3 +/- 59.2 cc, t = 4.4, p < 0.01, respectively).
The results suggest that increased relative renal function in hydronephrotic kidneys due to ureteropelvic junction obstruction is not an artifact of the DTPA renogram. It may represent a compensatory mechanism that sometimes may overcompensate resulting in a paradoxical hyperfunctioning kidney.
我们评估了喷替酸（DTPA）肾图中患侧肾功能差异增加是否代表梗阻性肾脏的肾功能升高。
对10例单侧输尿管肾盂连接部梗阻患者进行研究，其梗阻侧肾脏DTPA肾图显示患侧肾功能差异为53%或更高，我们对这些患者进行了肾脏二巯基丁二酸摄取的定量单光子发射计算机断层扫描。
与对侧正常肾脏相比，梗阻侧肾脏二巯基丁二酸的绝对摄取量显著更高（分别为30.0%±7.8与25.3%±8.2，t = 3.6，p < 0.01）。梗阻侧肾脏绝对摄取量升高是由于与对侧正常肾脏相比功能体积增加（分别为126.0±69.7 cc与102.3±59.2 cc，t = 4.4，p < 0.01）。
结果表明，由于输尿管肾盂连接部梗阻导致肾积水肾脏相对肾功能增加并非DTPA肾图的假象。它可能代表一种代偿机制，有时可能过度代偿，导致出现矛盾性高功能肾脏。
