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Annals of Nuclear Medicine and Molecular Imaging

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篇名 Comparison of 99mTc-DMSA Renal SPECT and Ultrasonography for Diagnosis of Acute Pyelonephritis in Children
卷期 16:3
並列篇名 比較鎝-99m-DMSA腎臟單光子電腦斷層掃描與超音波對兒童急性腎盂腎炎的診斷
作者 吳宜臻邱元佑姚維仁李碧芳邱南津吳佩珊
頁次 111-116
關鍵字 acute pyelonephritisultrasonography99mTc-DMSA renal SPECT急性腎盂腎炎鎝-99m-DMSA腎臟SPECT'超音波
出刊日期 200309

中文摘要

背景:由臨床及實驗室檢查來正確的診斷急性腎盂腎炎是不容易的,尤其是在兒童。本回溯性研究的主要目的為比較腎臟超音波與鎝-99m-DMSA腎臟單光子電腦斷層掃描(SPECT)在偵測兒童急性腎孟腎炎上的價值。
方法:本研究共收集了37位(26男,11女;年齡2週至9歲;平均年齡11個月)因發燒且經細菌培養證實有泌尿道感染而到本部門接受鎝-99m-DMSA腎臟SPECT檢查的兒童。我們紀錄其超音波與鎝-99m-DMSA腎臟SPECT的結果,並使用Wilcoxonsigned ranks test來分析兩者偵測率的不同。
結果:鎝-99m-DMSA腎臟SPECT偵測出51% (19/37)的病童有吻合於急性腎盂腎炎的變化;超音波則僅有32%(12/37)的病童顯現出吻合於急性腎盂腎炎的變化,而在有閃爍攝影證據為急性腎盂腎炎的病童中則只有47%(9/19)的超音波有吻合急性腎盂腎炎的變化。這兩種造影方式的偵測率之間的差異有統計學上的意義的(P<0.05)。另外,超音波發現 有16位病童(43%)有集尿系統擴張的情形。
結論:對於偵測急性腎盂腎炎,鎝-99m-DMSA腎臟SPECTJ比超音波更敏感。然而對於偵測可能與泌尿道感染有關的解剖學上的異常,超音波則是個有用的檢查。

英文摘要

Introduction: It is often difficult, especially in children, to accurately diagnose acute pyelonephritis (APN) through clinical and laboratory testing. The main goal of this retrospective study was to compare the values of renal ultrasonography (US) and technetium-99m dimercaptosuccinic acid ("9mTc-DMSA) single photon emission computed tomography (SPECT) in detecting APII in children.
Methods: We studied 37 children (26 boys, 11 gi; age range, 2 weeks to 9 years; mean, 11 months) with culture-documented febrile urinary tract infection. They were referred consecutively to our department for 99mTc_ DMSA renal SPECT. The scintigraphic and sonographic results were recorded to evaluate the values of US and 99mTc-DMSA renal SPECT. The Wilcoxon signed ranks test was performed to analyze the difference in detection rates of the two imaging modalities
Results: 99mTc-DMSA scans showed changes consistent with APII in 51 % (19/37) of the patients. US showed changes consistent with APII in 32% (12/37) of the whole group and in only 47% (9/19) of the patients with scintigraphically documented APII. There is a significant difference (P<0.05) between the detection rates of these two imaging modalities. Dilatation of the collecting system was noted in 16 patients (43%) by US
Conclusions: 99mTc-DMSA renal SPECT is a more sensitive method than US in detecting APII. However, US is useful in depicting anatomical abnormalities that may be associated with UTI.

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