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目的探讨99Tcm-DTPA肾动态显像在肾移植术后监测中的图像特征和临床价值。方法28例肾移植患者进行99Tcm-DTPA肾动态显像,同时测定移植肾的肾小球滤过率(GFR)和膀胱放射性计数与肾脏放射性计数比值(B/K值),定性和定量分析肾移植术后的影像特征。结果12例肾移植术后肾血流灌注及功能良好,GFR值为(51.5±6.3)ml/min,B/K均>3。6例急性排斥反应肾血流灌注受损程度重于功能相,GFR值为(33.4±5.7)ml/min,B/K均<1。7例慢性排斥反应肾血流灌注和功能相均同时受损,GFR值为(27.5±2.1)ml/min,B/K均<1。1例超急性排斥反应表现为放射性空白区。2例肾小管坏死肾血流灌注损伤轻于功能相。所有影像表现与临床或病理结果相吻合。结论99Tcm-DTPA肾动态显像可快速且定量评价移植肾的血流和功能,早期初步鉴别排斥反应的类别且具有无创、简单、重复性强的特点。
Objective To investigate the imaging features and clinical value of 99Tcm-DTPA renal dynamic imaging after renal transplantation monitoring. Methods Twenty-eight renal transplant recipients underwent 99Tcm-DTPA renal dynamic imaging. GFR and B / K ratio were measured at the same time. The renal function was analyzed qualitatively and quantitatively Image characteristics after transplantation. Results Renal perfusion and function were good in 12 cases after renal transplantation. The GFR value was (51.5 ± 6.3) ml / min and the B / K> 3.6 cases. The degree of renal perfusion injury in acute rejection was more than that in functional phase , GFR was (33.4 ± 5.7) ml / min and B / K was less than 1.7. Renal perfusion and functional lesion were also impaired at the same time. GFR was (27.5 ± 2.1) ml / / K <1.1 cases of hyperacute rejection showed radioactive blank area. 2 cases of renal tubular necrosis renal perfusion injury lighter than the functional phase. All imaging findings are consistent with clinical or pathological findings. Conclusion 99Tcm-DTPA renal dynamic imaging can rapidly and quantitatively evaluate the blood flow and function of allograft kidneys. The early identification of rejection can be performed initially and has the characteristics of non-invasive, simple and repetitive.