RESUMO
Objective How to examine the function of transplanted kidney more accurately and sensitively has become a fo?cus of clinical attention.This study was to investigate the value of 99Tcm?DTPA renal dynamic imaging in evaluating the function of trans?planted kidney by glomerular filtration( GFR) after transplantation. Methods Patients were collected from August 2015 to January 2016 in Nanjing General Hospital of Nanjing Military Region. GFR was measured in 74 cases of kidney transplantation patients using the 99Tcm?DTPA renal dynamic imaging.According to the range of serum creatinine,we divided the 74 cases into two groups:the normal group( n=17) and abnormal group( n=57) . We analysed the GFR between two groups and the correlation of GFR and serum creatinine .Transplanted kidney puncture biopsy was operated in 55 patients. We analysed the pathological results and compared the GFR. Results Compared with the abnormal group (GFR=37.7±15.4 mL/min),the average GFR was higher in the normal group(GFR =61.7±15.6 mL/min)(P<0.001). The average GFR(43.2±18.4 mL/min) measured by 99Tcm?DTPA renal dynamic imaging in 74 cases was positive correlated with average serum creatinine(1.84±0.82 mg/dL)(r=-0.673, P<0.001).Compared with patients with abnormal pathological results(GFR=39.6±16.5mL/min), normal people had higher average GFR ( GFR=59. 2 ± 8. 5 mL/min ) ( P=0. 040 ) . Conclusion 99 Tcm?DTPA renal dynamic imaging can reflect the function of transplanted kidney sensitively, it is one of the noninvasive examination to monitor the function in transplanted kidney.
RESUMO
Objective To investigate the feasibility and accuracy of dual energy CT myocardial iodine maps in detecting acute myocardial infarction in canine model. Methods Myocardial ischemia model was made by ligaturing left anterior descending coronary arteries (LAD) after thoracotomy in six dogs, while another 3 dogs undergoing thoracotomy not ligaturing LAD as control group. Before and three hours after operation, dual-source CT (DSCT) was performed, followed by resting 99Tcm-MIBI single photon emission computed tomography myocardial perfusion imaging. Then, dogs were sacrificed, and the hearts were removed, triphenyltetrazolium chloride staining and conventional HE staining were performed. CT number of non-ischemic and ischemic regions were measured and analyzed. The wall of the left ventricle in the short axis was divided into 17 segments, the segments of myocardial perfusion defect in DSCT myocardial iodine maps, SPECT, and pathology were determined. Student t test was used to analyze the difference of CT number between infarcted and non-infarcted myocardium. Kappa test was used for the accuracy of DSCT myocardial iodine maps and SPECT in detecting myocardial ischemia according to the pathological results. Results No abnormal regions were detected using DSCT myocardial iodine maps in preoperative control and infarction group. After thoracotomy, partial sparse or defective perfusion was consistently noted in six dogs' apical anterior and partition wall in both DSCT myocardial iodine maps and SPECT. In the infarcted group, the attenuation of infarction region (34.75 ± 16.66) HU was significantly decreased compared with preoperative measurements ( 123. 18 ± 15.38 ) HU ( t = 10. 526, P ＜ 0. 01 ); decreased perfusion in the infarcted region was also noted in the DSCT myocardial iodine maps and SPECT. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of DSCT myocardial iodine maps and SPECT were 85.0% (34/40) , 84. 1% (95/113) ,65.4% (34/52) ,94. 0%(95/101) ,and 82. 5% (33/40), 90. 3% ( 102/113 ) ,75.0% (33/44) ,93.6% ( 102/109 ), respectively.Kappa values were 0. 63 and 0. 71 for the agreement of DSCT myocardial iodine maps and SPECT.Conclusion DSCT myocardial iodine maps is comparable diagnostic accuracy with rest SPECT myocardial perfusion imaging in detection of acute myocardial infarction in a canine model.
