【摘要】 目的:探讨99 Tc m-MDP骨显像对分肾功能的判断价值。方法:收集2011-12-01-2013-06-01山东省肿瘤医院1周内进行99 Tc m-MDP骨显像和99 Tc m-DTPA肾动态显像的65例肿瘤患者,共130个肾,按肾功能异常类型分为A、B、C、D和E 5组,每组肾个数分别为62、25、20、10和13。A~D组为肾实质不同程度受损组,E组为肾排泄受损组。在全身骨显像图像上利用感兴趣区(region of intevest,ROI)技术勾画得出每个肾的总放射性计数(K)、平均计数(aK),全身骨显像图总计数(W)及平均计数(aW)。组间比较采用单因素方差分析,K、aK、K/W及aK/aW与肾小球滤过率(glomerular filtration,GFR)的相关性采用Pearson直线相关分析。结果:A~D 4组间GFR、K、aK、K/W、aK/aW值差异均有统计学意义,P值均<0.05;K、aK、K/W和aK/aW值D组与A组比较差异均有统计学意义,P值均<0.05;aK/aW值A组与C组比较差异有统计学意义,P值<0.01;而K、aK、K/W值A组与B组、C组两两比较差异均无统计学意义,P均>0.05;4组GFR与K、aK、K/W、aK/aW存在正相关关系,P<0.001。E组13个肾中1个GFR<35mL/min,12个均>35mL/min,GFR为(42.04±9.84)mL/min,K、aK、K/W和aK/aW分别为42 195.31±23 210.54、32.67±15.49、0.030±0.0122和4.283±1.539,与A、B、C、D组相应值比较差异有统计学意义,P值均<0.01;E组GFR与aK/aW存在负相关,r=-0.533,P=0.030,与K、aK、K/W不相关,P值均>0.05。结论:99 Tc m-MDP通过分析其肾脏影像对分肾功能状态具有一定的判断价值,而作为定量指标,aK/aW值对肾实质中度及以上受损与肾排泄功能受损均有较好的参考价值。更多还原

【Abstract】 OBJECTIVE:To evaluate the usefulness of the bone tracer 99 Tcm-MDP for assessment of differential renal function.METHODS:Sixty-five cases with 130 kidneys conducted 99 Tcm-MDP bone scintigraphy and 99 Tcm-DTPA renal dynamic imaging during one week were retrospectively analyzed.According to renal dysfunction type,they were divided into five groups(A,B,C,D and E group),and A-D group as renal parenchyma damage group,E group as impaired renal excretion group.On the use of regions of interest(ROI)on whole-body bone scintigraphy image,total radioactive counts(K)and the average count(aK)per kidney were measured,the same as total whole-body bone image radioactive counts(W)and the average count(aW).RESULTS:The differences of K,aK,K/W and aK/aW among A-D group were significant(P<0.05).The differences of K,aK,K/W and aK/aW values between Group A and D were statistically significant(P<0.05).For aK/aW value,the difference between Group A and C was significant(P<0.05).But for K,aK and K/W value,the differences of pairwise comparison among A group,B group and C group were not significant(P>0.05).The glomerular filtration rate(GFR)in A-D group showed significant and positive correlation with K(P<0.001),aK(P<0.001),K/W(P<0.001),aK/aW(P<0.001).For E group,the value of GFR was(42.04±9.84)mL/min,and one group was less than 35mL/min,but the rests were greater than 35mL/min.The value of K(42 495.31±23 210.54),aK(32.67±15.49),K/W(0.030±0.0122),aK/aW(4.283±1.539)in E group were significantly different with A-D group(P<0.01).The GFR in E group showed significant negative correlation with aK/aW(r=-0.533,P=0.030),but it showed no correlation with K,aK,K/W,P>0.05.CONCLUSIONS:99 Tcm-MDP bone scintigraphy has the value for analyzing differential renal function when screening bone metastases in patients with malignant tumor,as the quantification,the value of aK/aW has the great reference in moderate or above renal parenchyma damage and renal excretion damage.更多还原