De Sadeleer C, Bossuyt A, Goes E, Piepsz A
Department of Nuclear Medicine, Brussels, Belgium.
J Nucl Med. 1996 Aug;37(8):1346-9.
Dimercaptosuccinic acid (DMSA) renal scintigraphy today is considered a sensitive and useful technique for the detection of cortical abnormalities. Recent studies have suggested that lesion detection can be improved by SPECT imaging. This study investigated normal kidneys using different SPECT modalities.
Ten young, healthy volunteers with normal clinical history and normal renal ultrasound underwent planar and SPECT DMSA imaging 2 to 4 hr after intravenous injection of 99mTc-DMSA (185 MBq). Analysis of SPECT data was focused on the homogeneity of cortical uptake (comparison of upper and lower pole activity) as well as on the presence or absence of focal cortical defects.
No abnormality could be observed on the planar images. SPECT revealed, in seven kidneys (five left and two right), the presence of a hypoactive upper pole. This was visually observed on the coronal slices with up to 35% difference between upper and lower pole. Moreover, three focal cortical defects were visualized on the coronal slices as well as on three-dimensional surface shade displays.
These normal patterns should be recognized when evaluating a patient with possible renal involvement.
如今，二巯基丁二酸（DMSA）肾闪烁显像被认为是检测皮质异常的一种敏感且有用的技术。近期研究表明，单光子发射计算机断层扫描（SPECT）成像可提高病变检测率。本研究使用不同的SPECT模式对正常肾脏进行了调查。
10名临床病史正常且肾脏超声检查正常的年轻健康志愿者，在静脉注射99mTc-DMSA（185MBq）后2至4小时接受了平面和SPECT DMSA成像。SPECT数据的分析重点在于皮质摄取的均匀性（上下极活性比较）以及局灶性皮质缺损的有无。
平面图像上未观察到异常。SPECT显示，在7个肾脏（5个左侧和2个右侧）中，存在上极活性减低。在冠状位切片上可直观观察到，上下极之间差异高达35%。此外，在冠状位切片以及三维表面阴影显示上均可见3个局灶性皮质缺损。
在评估可能有肾脏受累的患者时，应认识到这些正常模式。
