신우성형술 후 이뇨성 DTPA 신주사 판독 시 신기능에 따른 신기능곡선, 연속 신스캔 영상 및 반감기의 유용성 비교
Comparison of the Effectiveness of the Renogram, the Serial Renal Scan and the Diuretic Half Time according to the Renal Function for Interpreting a Diuretic DTPA Scan following Pyeloplasty
남종길, 이상돈,
소속 상세정보
남종길 ( Nam Jong-Kil )
부산대학교 의과대학 비뇨기과학교실
이상돈 ( Lee Sang-Don )
부산대학교 의과대학 비뇨기과학교실
KMID : 0358320060470040402
Abstract
Purpose: The diuretic renal scan has been considered to be a good tool for evaluating the postoperative renal function in the patients with ureteropelvic junction obstruction(UPJO). We evaluated the diagnostic accuracy of the renogram, the serial renal scan and the diuretic half time according to the differential renal function(DRF) on the diuretic renal scan.
Materials and Methods: We reviewed the diuretic renal scans of 27 pediatric patients(25 males and 2 females) who underwent pyeloplasty due to unilateral UPJO. Diuretic renal scanning was done using the 99mTc- DTPA(diethylenetriaminepentaacetic acid) standardized protocol. We compared the diagnostic accuracy of the renogram, the serial renal scan and the diuretic half time according to the DRF(group I: above 40%, group II: below 40%).
Results: The mean age of the patients was 48.0±59.2 months(range: 2-210 months). The diuretic half time, renogram, serial renal scan and each combination demonstrated statistical significance for the interpretation of ureteral obstruction(generalized estimation equation, p=0.003). The interpretation of the diuretic renal scan was not affected by the DRF(McNemar test, p=0.598). The false positive rate and specificity of the renogram, serial renal scan and diuretic half time were 22.2%, 29.6%, 59.3% and 77.8%, 70.4%, 40.7%, respectively. In addition, the false positive rate and specificity of a combination of the diuretic half time and renogram, the diuretic half time and serial renal scan, the renogram and serial renal scan, the diuretic half time and renogram, and serial renal scan were 22.2%, 25.9%, 14.8%, 14.8%, and 77.8%, 74.1%, 85.2%, 85.2%, respectively.
Conclusions: The diuretic half time, renogram and serial renal scan were individually correlated with the postoperative status of the UPJO. However, a combination of various factors of the renal scan should be considered for evaluating the postoperative status of UPJO. (Korean J Urol 2006;47:402-406)
키워드
Radionuclide imaging;Ureteral obstruction;Follow-up studies
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