이식 신의 급성 거부 반응에 있어서 99mTc-DTPA 신스캔의 진단적 가치에 관한 연구

Abstract

In order to assess the usefulness of 09mTc·DTPA renal scan in diagnosing acute rejection renal graft, we performed 87 studies on 26 renal graft recipients. All the grafts except one were transplanted from living donors. The majority of the studies were made during the early posttransplantation period. At the time of scanning, the retrospectively confirmed clin· ical assessment of the graft function was normal in 75 studies, acute rejection in 10, acute tubular necrosis in one and renal artery stenosis in the other. As well as data obtained from scintillation camera images, computer-drived time-activity curves of renal perfusion were analyzed using 4 different parameters- aortorenal transit time. peak to plateau ratio, perfusion index, and T1/2 of washout phase. The perfusion curve of normal functioning kidney showed sharp peak follow by rapid declination of radioactivity. But the curve of acute rejection showed low, blunted peak and delayed washout in all cases, whereas that of acute tubular necrosis was relatively normal. Among the 4 perfusion parameters, Tl/2 revealed the highest diagnostic sensitivity (100%), that is, it was increased over 20 sec. in all acute rejection cases. And its specificity is 93.296. From the above results, we concluded that cornputer- processed 9OmTc·DTPA renal scan was useful in diagnosing acute rejection of transplanted kidney.