Everaert H, Flamen P, Franken P R, Peeters P, Bossuyt A, Piepsz A
Department of Nuclear Medicine, University Hospital, Free University of Brussels, Belgium.
Nucl Med Commun. 1996 Oct;17(10):884-9.
A number of authors have indicated a more sensitive detection of renal cortical defects using single photon emission tomography (SPET) compared with planar imaging when performing 99Tcm-dimer-captosuccinic acid (99Tcm-DMSA) renal scintigraphy. The place of SPET in the evaluation of kidneys in adults suspected of acute pyelonephritis (APN) remains controversial, however. The aim of this study was to address the role of SPET in adult patients suspected of having APN. Planar and SPET 99Tcm-DMSA renal imaging was performed in 53 patients. The data sets were separated and presented in random order to three independent observers. The kidneys were divided into three segments, which were classified as normal, definitely abnormal or equivocal. Ir. a second step, the number of lesions (definite or equivocal) on planar and SPET imaging were counted. The overall concordance between the planar and SPET imaging scores was 90.9, 89.9 and 87.7% for the three observers, respectively. Inter-observer discordance was recorded in a small percentage of both planar and SPET images. The number of lesions, based on the average of the three observers, was 22 for planar and 25 for SPET imaging. Obvious differences between observers were noted. The planar images were more often interpreted as equivocal by the least experienced observer. The more experienced observers gained limited additional information using SPET routinely. Most equivocal lesions on the planar scintigrams were observed in the lower segment. For SPET, no such distribution was noted. High-quality 99Tcm-DMSA images allow the detection of the same number of lesions as SPET in adults suspected of APN.
一些作者指出，在进行99锝-二聚体-半胱氨酸（99Tcm-DMSA）肾闪烁扫描时，与平面成像相比，单光子发射断层扫描（SPET）对肾皮质缺损的检测更为灵敏。然而，SPET在疑似急性肾盂肾炎（APN）的成人肾脏评估中的作用仍存在争议。本研究的目的是探讨SPET在疑似患有APN的成年患者中的作用。对53例患者进行了平面和SPET 99Tcm-DMSA肾显像。将数据集分开并以随机顺序呈现给三位独立的观察者。肾脏被分为三个节段，分别归类为正常、明确异常或可疑。第二步，对平面和SPET图像上的病变数量（明确或可疑）进行计数。三位观察者平面和SPET图像评分的总体一致性分别为90.9%、89.9%和87.7%。在平面和SPET图像中，观察者间不一致的情况均占较小比例。基于三位观察者的平均值，平面成像的病变数量为22个，SPET成像为25个。观察者之间存在明显差异。经验最少的观察者更常将平面图像解释为可疑。经验更丰富的观察者常规使用SPET获得的额外信息有限。平面闪烁图上大多数可疑病变出现在下段。对于SPET，未观察到这种分布情况。高质量的99Tcm-DMSA图像能够检测出与SPET相同数量的疑似APN成人患者的病变。
