Japanese
Title99mTc-DMSA腎シンチグラム・初期イメージによる腎血流動態の解析と腎疾患分類の試み
Subtitle原著
Authors川村寿一*, 細川進一*, 吉田修*,1), 藤田透**, 鳥塚莞爾**,1)
Authors(kana)
Organization*京都大学医学部泌尿器科学教室, **京都大学医学部核医学科教室, 1)主任:教授
Journal核医学
Volume15
Number8
Page1165-1173
Year/Month1978/12
Article原著
Publisher日本核医学会
Abstract「要旨」99mTc-DMSA腎シンチグラムの初期イメージは腎皮質における血流相を表わすので, DMSA投与後直ちに腎内血流にしたがって分布するDMSAカウントを90秒間追跡して, これをDMSAレノグラム曲線として提示することができた. この曲線を解析して, 腎皮質に初回分布する血流速度と血流量に関する4つのパラメーター (Cmax, Tmax, Tpl. , tanθ) を抽出した. Cmaxの異常は腎実質病変を, Tmaxのそれは腎血管病変を, Tpl. は残存機能ネフロンを, tanθは有効循環領域を, それぞれに表現し, 後期イメージによる形態学的変化や腎摂取率を考慮して, これらのパラメーターの変化の組合せから腎の血流動態を基盤にした腎疾患分類の可能なことが示された.
Practice臨床医学：一般
Keywords99mTc-DMSA renal scintigraphy, Early image, DMSA renogram, Cortical blood flow, Renal hemodynamics
English
TitleThe Implication of Renal Cortical Blood Flow Detected by 99mTc-Dimercaptosuccinic acid (DMSA) Renal Scintigraphy
SubtitleOriginal Articles
AuthorsJuichi KAWAMURA*, Shinichi HOSOKAWA*, Osamu YOSHIDA*, Toru FUJITA**, Kanji TORIZUKA**
Authors(kana)
Organization*Department of Urology, and **Department of Nuclear Medicine, Faculty of Medicine, Kyoto University
JournalThe Japanese Journal of nuclear medicine
Volume15
Number8
Page1165-1173
Year/Month1978/12
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] 99mTc-DMSA, renal scan agent, is perfused initially to the afferent and efferent arteries of the glomerulus followed by the renal blood flow and taken up to the tubular cells located within the cortical zone. This initial perfusion counts of DMSA can be traced as a DMSA renogram by a scinticamera and four parameters were extracted from the curve. i) Tmax (maximum peak time of the curve), ii) Cmax (counts at Tmax), iii) tanθ (an angle of the upslope part of the curve) and iv) Tplateau (Tpl. : the time when a constant count was obtained on the curve after passing a peak). In this study, those parameters were investigated in the variety of renal diseases and the implication was discussed. In the case of renal cell carcinoma with neovascularity of the cortex, Tmax and Tpl were prolonged, Cmax increased and tanθ was normal. In the case of hypertensive kidneys, while Tmax and Tpl were prolonged, Cmax was within normal limits. However, in nephrosclerosis, Cmax and tanθ decreased associated with prolonged Tmax and Tpl. In the case of mild hydronephrosis, while Cmax and Tmax decreased, Tpl and tanθ was within normal limits. On the extension of the severity of hydronephrosis, Tpl and tanθ were prolonged or decreased. In cases of glomerulonephritis and pyelonephritis with moderate lesions, while Tmax and Cmax decreased, Tpl and tanθ were still within normal limits. In the advanced case of such diseases and in the case of diabetic nephropathy, all parameters were decreased. From this study, Tmax indicates initial cortical blood flow rate, Cmax initial cortical distribution volume, Tpl effective perfusion rate and tanθ effective perfusion area. While abnormalities in Tmax and Tpl reveal pathologic changes in the cortical vascularity, those in Cmax and tanθ indicate cortical parenchymal disorders. Particularly, tanθ may indicate a functional balance between cortical perfusion rate and area. In conclusion, various combinations of the four parameters can allow to classify renal cortical diseases on the basis of renal hemodynamics.
PracticeClinical medicine
Keywords99mTc-DMSA renal scintigraphy, Early image, DMSA renogram, Cortical blood flow, Renal hemodynamics

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