NUCLEAR MEDICINE PROCEDURES IN HYPERTENSION

该提案旨在改进和评估核医学 高血压手术 开搏通放射性肾显像 肾血管性高血压（RVH）的鉴别诊断 被评价。 尚不清楚Tc 99 m-DTPA Captopril是否 肾造影CR或I-131 hippuran CR，带伽马照相机图像 具有可比价值。 Captopril的引入 肾造影有望大大提高诊断的准确性 的测试。 我们建议研究使用这两种药物的CR， 两个特定人群的高血压患者。 最初我们 将引导我们努力实现CR标准化。 技术 肾图和肾图曲线的评价， 变量如停药时间的长度，卡托普利的剂量， 患者的水合作用、研究的时间（同一天或 其他重要的变量（如： 中心之间的标准化，需要解决。 这些 研究将通过控制大鼠模型的研究来补充 具体的变量。 在优化这些参数后， 对有和无肾血管病变患者的初步评价 疾病，将进行更大的前瞻性系列， 确定CR的准确性。 基于一般人群的研究 是不可行的，但是通过使用两个明显不同的群体， 可以得到合理的估计。 人口丰富， 来自康奈尔医疗中心的肾血管性高血压患者 中心将提供关于真阳性和假阳性的数据 已知RVH的患者为阴性。 低流行 在阿尔伯特·爱因斯坦医学院研究的人口将 提供有关假阳性测试的数据。 自从少校 没有开搏通的肾造影术的困难是高假 阳性率，这两个群体将提供数据， 确定CR在鉴别诊断中的作用 高血压患者的肾血管疾病。 它将允许一个 估计假阳性率，这是最大的问题， 今天遇到的。 这项研究提供了一种标准化的手段， CR，选择最合适的同位素进行评价， 肾血管性高血压，并确定测试的能力 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.