Clorius J H, Hupp T, Zuna I, Schmidlin P, Denk S, van Kaick G
Department of Oncological Diagnostics and Therapy, German Cancer Research Center, Heidelberg, Germany.
J Nucl Med. 1997 Jul;38(7):1146-51.
The exercise renogram is a rarely used diagnostic procedure, but it may visualize an exercise-induced change in renal function related to the pathophysiology of essential hypertension, which could greatly increase interest in this examination. The aim of this study was to demonstrate the interpretative approach and the terminology which is used to describe results of exercise renography, using a population of hypertensives with renovascular disease.
We reviewed the examinations of 70 hypertensives who had supine renography as well as exercise renography with a 60-80 W work load. Forty-eight patients were examined with 99mTc-MAG3 and 22 with 131I hippurate. The renographic and angiography results were recorded as well as the antihypertensive drugs used and the site of vascular lesions.
Thirty-three hypertensives developed a bilateral-abnormal exercise renogram, which appears to be associated with primary hypertension. Eight individuals responded to exercise with a unilateral-abnormal exercise renogram, in a kidney behind a stenosis. Only 19 patients had a normal exercise renogram, and 10 had only one functioning kidney. Pathology recognized but unrelated to the intervention included nonfunctioning and small kidneys and pelvic retention.
Exercise renography's only indication is for recognition of pathology unique to hypertension, since other function disturbances were recognized in resting renograms.
运动肾图是一种很少使用的诊断程序，但它可以显示与原发性高血压病理生理学相关的运动诱发的肾功能变化，这可能会大大增加人们对这项检查的兴趣。本研究的目的是使用患有肾血管疾病的高血压患者群体，展示运动肾图结果的解释方法和术语。
我们回顾了70例高血压患者的检查，这些患者进行了仰卧位肾图以及60 - 80瓦工作量的运动肾图检查。48例患者使用99mTc - MAG3进行检查，22例使用131I马尿酸盐进行检查。记录了肾图和血管造影结果，以及使用的降压药物和血管病变部位。
33例高血压患者出现双侧异常运动肾图，这似乎与原发性高血压有关。8例患者在狭窄肾脏后方出现单侧异常运动肾图。只有19例患者运动肾图正常，10例患者只有一个功能肾。所识别出的但与干预无关的病理情况包括无功能的小肾脏和盆腔潴留。
运动肾图的唯一指征是识别高血压特有的病理情况，因为在静息肾图中也识别出了其他功能障碍。
