| Japanese |
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| Title | 閉塞性尿路疾患における利尿レノグラム (Diuretic Renogram) の臨床的評価 |
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| Subtitle | 原著 |
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| Authors | 伊藤和夫*, 今中香里**, 野々村克也**, 小柳知彦** |
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| Organization | *北海道大学医学部附属病院放射線部, **北海道大学医学部泌尿器科学教室 |
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| Journal | 核医学 |
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| Volume | 19 |
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| Number | 5 |
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| Page | 721-732 |
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| Year/Month | 1982/6 |
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| Article | 原著 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」閉塞性尿路疾患44例に対し施行した利尿剤併用レノグラム(diuretic renography)57回に関し, その臨床的意義に関し検討し報告した. 利尿レノグラムは, Kruegerらの方法を参考にして施行した. 利尿剤投与後, 腎盂・腎杯部の放射活性は片対数グラフ上, Mono-compartmentalな直線的低下を示し, 正常腎では, その半減時間(D-T1/2)は4.41±2.73分であった. この利尿排泄パターンは, 非直線的排泄曲線を示す症例も含めると4群に分類された. 術前腎で手術適応腎は, 正常排泄(I), 遅延排泄(不完全)(III)や閉塞(IV)群が占められ全腎とも腎血液灌流の低下が示された. 術前腎ではD-T1/2, 利尿排泄曲線パターンとスキャン情報の総合的把握が手術適応腎の判定には必要である. 術後腎に関しては, D-T1/2と利尿排泄曲線パターンが尿通過動態の把握に有用であった. 利尿レノグラムは, 閉塞性尿路疾患の疑われる症例や尿路再建術後症例の尿通過動態を把握する上で, IVPとは異なった情報が得られ, 幼小児にも安全にかつ非侵襲的に施行しうる臨床検査の一つである. |
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| Practice | 臨床医学：一般 |
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| Keywords | Diuretic Renography, obstructive Uropathy, 99mTc-DTPA, Furosemide(Lasix). |
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| English |
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| Title | Clinical Evaluation of Diuretic Renography in Obstructive Uropathy |
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| Authors | Kazuo ITOH*, Kaori IMANAKA**, Katsuya NONOMURA**, Tomohiko KOYANAGI** |
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| Authors(kana) | |
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| Organization | *Department of Radiology, Hokkaido University Hospital, **Department of Urology, Hokkaido University School of Medicine |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 19 |
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| Number | 5 |
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| Page | 721-732 |
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| Year/Month | 1982/6 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary]Diuretic renography assisted with Lasix was performed in 44 cases with obstructive uropathy. The procedure was done in four steps, (1) hydration with an intake of water 10 to 20 minutes before the examination, (2) non-diuretic (regular) dynamic renal scan with 99mTc-DTPA for 20 minutes. (3) Voiding and (4) post-voiding diuretic dynamic renal scan followed an i. v. injection of Lasix (0.4-0.5 mg/kg, Max 20 mg) at 2 minutes for 15 minutes. Quantitative analysis of the time-activity curves which were obtained from data stored as 64×64 matrix per frame of 10 seconds during imaging was simultanously performed on a computer system. Most of kidneys showed a prompt linear, mono-compartmental excretion in a semi-logarithmic scale after the administration of diuretics. Mean half time (D-T1/2) and S. D. of diuretic excretion in normal Kidneys was 4.41+-2.73 minutes and reactive duration 2.04+-1.23. The excretion pattern of these diuretic renograms showed four different groups, (I) linear decrease with D-T1/2 under 10 min. , (II) linear with D-T1/2 between 10 to 20 min. (III) linear with D-T1/2 over 20 Min. and non-linear and (IV) flat or elevated excretion. All of preoperative obstructive kidneys urologically indicated of the operation showed excretion pattern of I, III and IV with decrease in a blood perfusion on non-diuretic dynamic images. This finding is appreciated of significance evaluating the indication of an operation to the affected kidney. However, many of the postoperative kidneys showed such decrease persisted. In those kidneys, diuretic T1/2 and excretion patterns were useful for following-up the uro-dynamic change after the reconstration performed in urinary tracts. |
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| Practice | Clinical medicine |
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| Keywords | Diuretic Renography, obstructive Uropathy, 99mTc-DTPA, Furosemide(Lasix). |
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