Inoue Y, Ohtake T, Homma Y, Yoshikawa K, Nishikawa J, Sasaki Y
Department of Radiology, Institute of Medical Science, University of Tokyo, Japan.
J Nucl Med. 1998 Oct;39(10):1784-8.
We describe a method to evaluate glomerular filtration rate (GFR) in both children and adults using 99mTc-diethylenetriamine pentaacetic acid (DTPA) and a gamma camera.
Renal scintigraphy with 99mTc-DTPA was performed in 40 children and 92 adults with various degrees of renal function. The percent renal uptake at 2-2.5 min after tracer arrival in the kidney was determined with background subtraction and correction for soft-tissue attenuation and was correlated by linear regression analysis with GFR measured from two blood samples. A perirenal region of interest was used for background subtraction. Renal depth was computed using the equations determined or validated on the basis of CT measurements, and the attenuation coefficient was set at 0.12. The obtained regression equation was used to predict GFR. Renal function was also assessed by the Gates' method.
Percent renal uptake was closely correlated with GFR normalized for body surface area in all patients (y = 15.958x - 2.94; r = 0.939). GFR was successfully predicted using the regression equation in both children and adults. Gates' method severely overestimated GFR in children and provided less accurate values even in adults than our method.
The method presented here requires neither blood sampling nor additional imaging and allows estimation of GFR in both children and adults.
我们描述了一种使用99mTc-二乙三胺五乙酸（DTPA）和γ相机评估儿童和成人肾小球滤过率（GFR）的方法。
对40名儿童和92名不同程度肾功能的成人进行了99mTc-DTPA肾闪烁显像。在示踪剂到达肾脏后2 - 2.5分钟时，通过背景扣除以及软组织衰减校正来确定肾脏摄取百分比，并通过线性回归分析将其与从两份血样测得的GFR相关联。使用肾周感兴趣区进行背景扣除。根据基于CT测量确定或验证的公式计算肾脏深度，并将衰减系数设定为0.12。所得回归方程用于预测GFR。还通过盖茨法评估肾功能。
所有患者的肾脏摄取百分比与经体表面积标准化的GFR密切相关（y = 15.958x - 2.94；r = 0.939）。使用回归方程在儿童和成人中均成功预测了GFR。盖茨法在儿童中严重高估了GFR，并且即使在成人中提供的值也比我们的方法更不准确。
本文介绍的方法既不需要采血也不需要额外的成像检查，并且能够在儿童和成人中估算GFR。
