Interpretation of the renogram:: problems and pitfalls in hydronephrosis in children
Interpretation of the renogram:: problems and pitfalls in hydronephrosis in children
复制标题
DOI：
10.1111/j.1464-410x.2004.05052.x
复制
发表时间：
2004-10-01
影响因子：
4.5
通讯作者：
Frokiær, J
中科院分区：
文献类型：
--
作者：
Eskild-Jensen, A;Gordon, I;Frokiær, J
目的探讨肾脏造影技术的主要步骤，强调利尿肾造影的获取、处理和解释中存在的问题，这是指导无症状先天性肾积水治疗的重要方法。方法：尽管有指南和共识协议，各中心的肾造影程序不同，导致比较困难和结果解释的争议。因此，我们综合评估了已发表的关于利尿肾造影的论文。结果如果有足够的背景减法，鉴别肾功能（DRF）是一种稳健的测量方法。陷阱与绘制感兴趣的区域有关，特别是在婴儿中，估计计算DRF的间隔，以及适当的信噪比。没有关于“显著”减少DRF的定义。利尿肾图的经典变量可能无法估计最佳引流。骨盆排空不良可能是明显的，因为膀胱充满，因为重力对引流的影响不完全。用残余活动性而不是斜坡上的任何参数来估计排水可能更合适，特别是如果改变了氟塞米的施用时间。肾功能和盆腔容积会影响引流质量。使用新工具可以更好地估计排水情况。结论如果调查规范，并考虑到潜在的缺陷，利尿剂肾图提供了有价值的、可重复的DRF和引流的定量信息。
OBJECTIVETo discuss the main steps of renographic technique and underline some pitfalls related to the acquisition, processing and interpretation of diuretic renography, an important method for guiding the management of asymptomatic congenital hydronephrosis.METHODSDespite guidelines and consensus protocols, renographic procedures differ among centres, causing difficulties in comparison and controversy in the interpretation of results. Thus we comprehensively assessed published papers on the subject of diuretic renography.RESULTSDifferential renal function (DRF) is a robust measure provided there is adequate background subtraction. Pitfalls are related to the drawing of regions of interest, particularly in infants, to estimating the interval during which DRF is calculated, and to an adequate signal-to-noise ratio. There is no definition of a 'significant' reduction in DRF. The classical variables of the diuretic renogram may not allow an estimate of the best drainage. Poor pelvic emptying may be apparent because the bladder is full and because the effect of gravity on drainage is incomplete. Estimating the drainage as residual activity rather than any parameter on the slope might be more adequate, especially if the time of frusemide administration is changed. Renal function and pelvic volume can influence the quality of drainage. Drainage may be better estimated using new tools.CONCLUSION Provided the investigation is standardized and potential pitfalls accounted for, the diuretic renogram provides valuable and reproducible quantitative information on DRF and drainage.