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KMID : 1143620160200020027
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Korean Journal of Nuclear Medicine Technology
2016 Volume.20 No. 2 p.27 ~ p.31
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Study on the Difference in Intake Rate by Kidney in Accordance with whether the Bladder is Shielded and Injection method in 99mTc-DMSA Renal Scan for Infants
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Park Jeong-Kyun
Cha Jae-Hoon
Kim Kwang-Hyun
An Jong-Ki
Hong Da-Yeong
Seong Hyo-Jin
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Abstract
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Purpose : 99m Tc-DMSA renal scan is a test for the comparison of the function by imaging the parenchyma of the kidneys by the cortex of a kidney and by computing the intake ratio of radiation by the left and right kidney. Since the distance between the kidneys and the bladder is not far given the bodily structure of an infant, the bladder is included in the examination domain. Research was carried out with the presumption that counts of bladder would impart an influence on the kidneys at the time of this renal scan. In consideration of the special feature that only a trace amount of a RI is injected in a pediatric examination, research on the method of injection was also carried out concurrently.
Materials and Methods : With 34 infants aged between 1 month to 12 months for whom a 99m Tc-DMSA renal scan was implemented on the subjects, a Post IMAGE was acquired in accordance with the test time after having injected the same quantity of DMSA of 0.5mCi. Then, after having acquired an additional image by shielding the bladder by using a circular lead plate for comparison purposes, a comparison was made by illustrating the percentile of (Lt. Kidney counts + Rt. Kidney counts)/ Total counts, by drawing the same sized ROI (length of 55.2mm X width of 70.0mm). In addition, in the format of a 3-way stopcock, a Heparin cap and direct injection into the patient were performed in accordance with RI injection methods. The differences in the count changes in accordance with each of the methods were compared by injecting an additional 2cc of saline into the 3-way stopcock and Heparin cap.
Results : The image prior to shielding of the bladder displayed a kidney intake rate with a deviation of 70.9±3.18% while the
image after the shielding of the bladder displayed a kidney intake rate with a deviation of 79.4±5.19%, thereby showing approximately 6.5~8.5% of difference. In terms of the injection method, the method that used the 3-way form, a deviation of 68.9±2.80% prior to the shielding and a deviation of 78.1±5.14% after the shielding were displayed. In the method of using a Heparin cap, a deviation of 71.3±5.14% prior to the shielding and a deviation of 79.8±3.26% after the shielding were displayed. Lastly, in the method of direct injection into the patient, a deviation of 75.1±4.30% prior to the shielding and a deviation of 82.1±2.35% after the shielding were displayed, thereby illustrating differences in the kidney intake rates in the order of direct injection, a Heparin cap and the 3-way methods.
Conclusion : Since a substantially minute quantity of radiopharmaceuticals is injected for infants in comparison to adults, the cases of having shielded the bladder by removing radiation of the bladder displayed kidney intake rates that are
improved from those of the cases of not having shielded the bladder. Although there are difficulties in securing blood vessels, it is deemed that the method of direct injection would be more helpful in acquisition of better images since it displays improved kidney intake rate in comparison to other methods.
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KEYWORD
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Infant, Kidney, Shielding, 3-way stopcock, Heparin cap
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