대한핵의학회지 (1967년~2009년)
대한핵의학회지 2004;38(6)498~505
99mTc-diethylenetriaminepentaacetic acid 캅토프릴 신장스캔의 단측 신동맥 협착에 의한 신혈관성고혈압 진단 기준
(Diagnostic Criteria of 99mTc-diethylenetriaminepentaacetic acid Captopril Renal Scan for the Diagnosis of Renovascular Hypertension by Unilateral Renal Artery Stenosis)
Author 최승진1, 홍일기1, 장재원2, 박수길2, 문대혁1,
Seung Jin Choi1, M.D., Il Ki Hong1, M.D., Jae Won Chang2, M.D., Su Kil Park2, M.D.,Dae Hyuk Moon1, M.D.
Affiliation 울산대학교 의과대학 서울아산병원 핵의학과1, 신장내과2
Department of Nuclear Medicine1 and Internal Medicine2, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Abstract

Purpose: We compared captopril renal scintigraphic criteria for the diagnosis of renovascular hypertension by unilateral renal artery stenosis. Materials and Methods: The study group consisted of 24 patients (m/f =16/8, age: 39±18 years) with unilateral renal artery stenosis who underwent renal artery revascularization and captopril renal scintigraphy with 99mTc-diethylenetriaminepentaacetic acid between May 1995 and April 2004. The blood pressure response was classified as cure/improvement or failure. We evaluated captopril-induced changes in relative function (BCfun) and renogram grade (0 to 5: 0 = normal, and 5 = renal failure pattern without measurable uptake) (CBren) and the difference of renograms between the normal and stenotic kidney on captopril scan (CNren). Results: Eight of 24 patients were cured and 11 improved and 5 patients were classified as failed revascularization. Significant predictors of a cure or improvement of blood pressure were younger age, stenosis by fibromuscular dysplasia or arteritis, BCfun, CBren and CNren. Areas under the receiver operating characteristic curve of age, BCfun, CBren and CNren were not significantly different. Positive and negative predictive values of predictors were 100% and 42% (age ≤ 38); 92% and 50% (BCfun ≥ 1%); 92% and 75% (CBren ≥ 1), and 90% and 60% (CNren ≥ 1), respectively. Conclusion: Captopril induced changes in renal function and renogram can reliably predict hypertension response to revascularization. Renogram pattern on captopril scan can diagnose renovascular hypertension without baseline data in patients with unilateral renal artery stenosis.(Korean J Nucl Med 38(6):498-505, 2004)

Keyword renovascular hypertension, renal artery stenosis, captopril renal scintigraphy
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