NUCLEAR MEDICINE PROCEDURES IN HYPERTENSION

该提案旨在改进和评估核医学 高血压的治疗程序。卡托普利的放射肾造影术 肾性高血压(RVH)的鉴别诊断 被评估。目前尚不清楚Tc99m-DTPA卡托普利 带有伽马相机图像的肾成像CR或I-131河马CR 都具有相当的价值。卡托普利在临床上的应用 肾造影术有望大大提高诊断的准确性。 测试的结果。我们建议使用这两种试剂在 两个特定人群的高血压患者。最初，我们 将引导我们的努力使CR标准化。技术： 闪烁图和肾图曲线的评价，控制 变量，如停药时间，卡托普利剂量， 患者的水合情况、研究时间(同一天或 连续天数)，以及其他重要变量没有 中心之间的标准化，需要解决。这些 这些研究将得到控制老鼠模型的研究的补充 对于特定的变量。在通过一个 有肾血管和无肾血管患者的初步评估 疾病，将开展更大规模的前瞻性系列研究 确定CR的准确性。一项基于总体的研究 是不可行的，但通过使用两个截然不同的种群， 可以得到合理的估计。一个人口丰富的国家 来自康奈尔大学医学院的肾血管性高血压患者 中心将提供有关真阳性和假阳性的数据 已知的RVH患者均为阴性。低流行率 在阿尔伯特·爱因斯坦医学院学习的人将 提供有关假阳性检测的数据。因为少校 没有卡托普利的肾造影术困难是高度错误的 阳性率，这两个人群将提供数据 CR在乳头状瘤鉴别诊断中的作用 高血压病患者的肾血管疾病。它将允许一个 估计假阳性率，这是最大的问题 今天遇到了。这项研究提供了一种标准化的手段 选择最合适的同位素来评价 肾血管性高血压，并测定能力测试 以提供鉴别诊断价值的信息。

This proposal aims to improve and evaluate Nuclear Medicine procedures in hypertension. Radiorenography with Captopril in the differential diagnosis of renovascular hypertension (RVH) will be evaluated. It is not clear whether Tc99m-DTPA Captopril renography CR or I-131 hippuran CR with gamma camera images are of comparable value. The introduction of Captopril to renography promises to greatly improve the diagnostic accuracy of the test. We propose to study CR using both of these agents in two specific populations of hypertensive patients. Initially, we will direct our efforts towards standardizing CR. Techniques for evaluation of the scintigrams and renographic curves, control of variables such as length of time off medication, dose of captopril, hydration of the patient, timing of the study (same day or sequential days), and other significant variables have not been standardized among centers and need to be addressed. These studies will be complemented by studies in rat models controlling for specific variables. After optimizing these parameters by an initial evaluation of patients with and without renovascular disease, a larger prospective series will be carried out to determine the accuracy of CR. A general population based study is not feasible, but by using two distinctly different populations, reasonable estimates may be obtained. A population rich in patients with renovascular hypertension from the Cornell Medical Center will provide data concerning true positives and false negatives in patients with known RVH. A low prevalence population studied at the Albert Einstein College of Medicine will provide data concerning false positive tests. Since the major difficulty with renography without Captopril is the high false positive rate, these two populations will provide data to determine the role of CR in the differential diagnosis of renovascular disease in the hypertensive patient. It will permit an estimation of the false positive rate, which is the biggest problem encountered today. This study provides a means of standardizing CR, choosing the most suitable isotope for evaluation of renovascular hypertension, and determining the ability of the test to provide information of differential diagnostic value.