成人 99mTc-DTPA 动态 SPECT/CT 肾图:可行性和诊断效果。

IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Nuclear Medicine Communications Pub Date : 2024-08-01 Epub Date: 2024-05-23 DOI:10.1097/MNM.0000000000001865
Maria Spiliotopoulou, Nikolaos Papathanasiou, Łukasz Łabieniec, Evangelos Papachristou, Eleftherios Fokaefs, Trifon Spyridonidis, Andreas Fotopoulos, Dimitrios J Apostolopoulos
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引用次数: 0

摘要

研究目的本研究旨在探讨 99mTc-DTPA 动态单光子发射计算机断层扫描/计算机断层扫描(SPECT/CT)肾图在成人中的可行性和潜在优势:方法:入组 55 名患者,年龄 19-80 岁(平均 56.3 岁)。成像方案包括:第1天:99m锝-DTPA平面肾图,然后是99m锝-DMSA平面扫描。第3天:衰减校正动态99m锝-DTPA SPECT肾图[DSPECT(AC)]和Cr-51乙二胺四乙酸(EDTA)肾小球滤过率(GFR)计算。DSPECT(AC)包括初始CT扫描,然后通过连续模式采集进行12次连续SPECT扫描,共24分钟。前 8 分钟采用快速 SPECT 序列(1-2 秒/投影,60 次投影,每 6°一次),其余时间采用慢速采集(3-4 秒/投影)。通过在第三次 SPECT 的连续横轴切片上绘制感兴趣区来测量肾脏总体积中的肾脏活动,然后将这些感兴趣区复制到整个 12-SPECT 系列上。绘制了相应的时间-活动曲线。将 DSPECT(AC)参数与平面肾图参数进行比较。分割肾功能的参考方法是 99m锝-DMSA(前后投影计数的几何平均数),肾小球滤过率的参考方法是 Cr-51 EDTA 2 血样清除法:DSPECT(AC)图像质量良好。两种技术的肾图参数(峰值活动时间和 NORA20)之间的相关性很好(r 分别为 0.959 和 0.933)。在两个肾脏绝对差值大于 30% 的 21 个病例中,DSPECT(AC) 的肾功能计算与参考方法完全相关(r = 0.968),而平面肾图的准确性较低(r = 0.843)。非增强 CT 提供的解剖信息为最终诊断提供了结构和功能的综合视图。结论:99m锝-DTPA动态SPECT/CT肾图在常规SPECT/CT系统中是可行的。结论:99m锝-DTPA动态SPECT/CT肾图与传统SPECT/CT系统相比是可行的,它能精确测量分流肾功能,提供额外的解剖信息,与盖茨法相比更接近GFR。
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99m Tc-DTPA dynamic SPECT/CT renogram in adults: feasibility and diagnostic benefit.

Objective: The objective of this study is to investigate the feasibility and potential advantages of 99m Tc-DTPA dynamic single photon emission computed tomography/computed tomography (SPECT/CT) renogram in adults.

Methods: Fifty-five patients aged 19-80 years (mean 56.3) were enrolled. The imaging protocol included: day 1: 99m Tc-DTPA planar renogram, followed by planar 99m Tc-DMSA scan. Day 3: attenuation-corrected dynamic 99m Tc-DTPA SPECT renogram [DSPECT(AC)] and Cr-51 ethylenediamine tetraacetic acid (EDTA) glomerular filtration rate (GFR) calculation. DSPECT(AC) included an initial CT scan followed by 12 consecutive SPECT sessions acquired via continuous-mode acquisition for a total of 24 min. Fast SPECT sequences (1-2 s/projection, 60 projections, every 6°) were obtained for the first 8 min, followed by slower acquisitions (3-4 s/projection) during the rest of the study. Renal activity was measured in the total kidney volume by regions of interest drawn on consecutive transaxial slices of the third SPECT, which were then copied on the whole 12-SPECT series. Corresponding time-activity curves were created. DSPECT(AC) parameters were compared with those of planar renogram. The reference method for split renal function was 99m Tc-DMSA (geometrical mean of anterior and posterior projection counts) and for GFR the Cr-51 EDTA 2-blood sample clearance method.

Results: DSPECT(AC) images were of good quality. There was good correlation between renogram parameters (time to peak activity and NORA20) comparing the two techniques ( r  = 0.959 and 0.933, respectively). In 21 cases with >30% absolute difference between the two kidneys, spilt renal function calculation by DSPECT(AC) correlated perfectly ( r  = 0.968) with the reference method, whereas planar renogram was less accurate ( r  = 0.843). Anatomic information provided by nonenhanced CT offered an integrated structural-functional view valuable for final diagnosis. DSPECT(AC) early kidney uptake as a fraction of injected dose correlated better with reference GFR ( r  = 0.789) than the Gates' method ( r  = 0.642).

Conclusion: 99m Tc-DTPA dynamic SPECT/CT renogram is feasible with conventional SPECT/CT systems. It allows accurate split renal function measurement, offers additional anatomical information and can be used for closer approximation of GFR compared with Gates' method.

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来源期刊
CiteScore
2.20
自引率
6.70%
发文量
212
审稿时长
3-8 weeks
期刊介绍: Nuclear Medicine Communications, the official journal of the British Nuclear Medicine Society, is a rapid communications journal covering nuclear medicine and molecular imaging with radionuclides, and the basic supporting sciences. As well as clinical research and commentary, manuscripts describing research on preclinical and basic sciences (radiochemistry, radiopharmacy, radiobiology, radiopharmacology, medical physics, computing and engineering, and technical and nursing professions involved in delivering nuclear medicine services) are welcomed, as the journal is intended to be of interest internationally to all members of the many medical and non-medical disciplines involved in nuclear medicine. In addition to papers reporting original studies, frankly written editorials and topical reviews are a regular feature of the journal.
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