3D dynamic diuretic renal scintigraphy using a hybrid whole body CZT SPECT/CT camera protocol in the evaluation of acute ureteric obstruction caused by ureteric stone

被引：1

作者：

Ochoa-Figueroa, Miguel ^{[1
,2
,3
,4
,5
]}

Borbely, Klara ^{[3
,4
]}

Hasselqvist, Diana ^{[4
,6
]}

Askling, Fredrik ^{[1
,2
]}

Loow, Tobias ^{[1
,2
]}

Aljabery, Firas ^{[7
]}

Sanchez-Rodriguez, Veronica ^{[1
,2
,3
,4
]}

机构：

[1] Linkoping Univ, Dept Clin Physiol Linkoping, S-58185 Linkoping, Sweden

[2] Linkoping Univ, Dept Hlth Med & Caring Sci, S-58185 Linkoping, Sweden

[3] Linkoping Univ, Dept Radiol, Linkoping, Sweden

[4] Linkoping Univ, Dept Hlth Med & Caring Sci, Linkoping, Sweden

[5] Linkoping Univ, Ctr Med Image Sci & Visualizat CMIV, Linkoping, Sweden

[6] Linkoping Univ, Emergency Dept Linkoping, Linkoping, Sweden

[7] Linkoping Univ Hosp, Dept Clin & Expt Med, Div Urol, Linkoping, Sweden

来源：

EJNMMI REPORTS | 2024年 / 8卷 / 01期

关键词：

Stone; Ureteral obstruction; SPECT; CT; Cadmium-zinc-telluride; MANAGEMENT; MAG(3)-F-0; GUIDELINE; ADULTS; PAIN; CT;

D O I：

10.1186/s41824-024-00213-9

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

PurposeTo investigate the performance of dynamic 3D diuretic renal scintigraphy using a hybrid whole body CZT SPECT/CT for the evaluation of acute ureteric obstruction in patients with urinary stone disease.Methods20 patients who presented to the Emergency Department with acute renal colic due to urinary stone disease confirmed by means of CT were prospectively included. Three observers evaluated and graded hydronephrosis, hydroureter, perirenal stranding, and thickening of the renal fascia from the CT as well as the renal scintigraphy curves from the dynamic SPECT study. The normalized residual activity from dynamic SPECT was analysed at 16 min in all patients and at 20 min in suspected obstruction.ResultsRenal scintigraphy curves showed a sensitivity of 100%, specificity of 93%, PPV 83% and a NPV 100% for obstruction, while normalized residual activity showed a sensitivity of 100%, specificity of 73%, PPV 56% and a NPV 100%. All patients presented at least 2 secondary signs of obstruction on the CT, showing a PPV of only 25% for obstruction.ConclusionDynamic 3D diuretic renal scintigraphy CZT SPECT/CT provides valuable functional and anatomical information from one single examination. The combination of pathological renogram curves and high normalized residual activity values provide the most valuable imaging information to determine the presence of acute ureteric obstruction. The secondary signs of obstruction observed on CT are not specific and should not be used to confirm or discard obstruction in patients with urinary stone disease.Trial registration: ISRCTN15338358. Registration date 03/01/2024. Retrospectively registered. https://www.isrctn.com/ISRCTN15338358?q=miguel%20ochoa%20figueroa&filters=&sort=&offset=1&totalResults=2&page=1&pageSize=10ConclusionDynamic 3D diuretic renal scintigraphy CZT SPECT/CT provides valuable functional and anatomical information from one single examination. The combination of pathological renogram curves and high normalized residual activity values provide the most valuable imaging information to determine the presence of acute ureteric obstruction. The secondary signs of obstruction observed on CT are not specific and should not be used to confirm or discard obstruction in patients with urinary stone disease.Trial registration: ISRCTN15338358. Registration date 03/01/2024. Retrospectively registered. https://www.isrctn.com/ISRCTN15338358?q=miguel%20ochoa%20figueroa&filters=&sort=&offset=1&totalResults=2&page=1&pageSize=10

引用

页数：16