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KMID : 0363819930270020239
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Korean Journal of Nuclear Medicine
1993 Volume.27 No. 2 p.239 ~ p.247
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Quantitative Assessment of Obstructive Uropathy with Diuretic Renography in Children
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김종호
이동수/곽철은/이경한/최창운/정준기/이명철/고창순/최용
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Abstract
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Differentiating the various causes of hydronephrosis from that of obstruction can be very difficult. The decision-making process for those instances of urinary tract dilatation that require surgical correction and those that do not is based in
part
on
the findings of diuresis renography. The methodology for performing this test has differed among nuclear medicine practitioners and the surgical findings are occasionally discrepant from the diuretic renogram interpretation. Consequently we made
an
automatic computer software program that calculates the slope of the response curve. The quantitative indices, such as the injection and response t1/2 by linear-fitting and monoexponential-fitting, were compared with the visual assessment of the
diuretic cinerenography and clinical outcome in 50 children (62 kidneys) with ureteropelvic junction obstruction.
Pooled diuresis renogram data indicated that : (1) Visual evaluation of the diuretic cinerenography is a sensitive (87%, 54/62) tool to differentiate obstruction in suspected ureteropelvic junction obstruction. (2) The cut-off value (maximum
washout
t1/2 with non-obstruction) of injection and response t1/2 by linear-fitting were 40 min. (3) The sensitivity and specificity using injection and response t1/2 by linear-fitting for obstruction were 89% (23/26) and 100% (30/30), respectively. (4)
Response t1/2 as well as injection t1/2 by monoexponential-fitting do not stratify children with possible ureteropelivic junction obstruction.
In conclusion, quantitative assessment of diuretic renography as well as visual assessment of diuretic cinerenography correlate well with surgical and clinical outcome of suspected ureteropelvic junction obstruction.
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