核醫(yī)學教學課件：10-腎圖

1、RENOGRAPHYcontents Renography basic knowledge of renography normal renography and its principle abnormal renography and its clinical applicationDiuretic renography its principle and clincal applicationSome renographies from clinic RENOGRAPHY1、definition A renography is simply a time-activity curve u

2、sing renogram equipment after the bolus intravenous injection of a radiopharmaceutical. It provides a graphic representation of the renal function and the conditions of upper urinary tract.time-activity curve radioactivitytimeIt is a routine examination.simple and convenientnon-invasiveprovides the

3、function of each kidney2、radioactive tracerradioiodinated ortho iodiohippurate (sodium)131I-OIH99mTc-diethylenetriaminepenta acetic acid99mTc-DTPA99mTc-labeled agent mertiatide99m Tc-MAG33、principle 131I-OIH bolus intravenous injected uptaken and secreted by renal tubular epithelial cells renal pelv

4、is ureter bladder .4、method4.preparation4.administration4.examinationhistory-takinghydrated (drink water 300ml)urinationbolus injection 131I-OIH 185-370kBq(5-10Ci)initiating the equipment at the same time of injectioninformation displayed about 15 to 20 min after injection5、normal renographyThe norm

5、al renography consists of three phases.phase a : patent period phase b : aggregation period phase c : excretion period radioactivitytime(minutes)5. phase aA steeply rising curve lasting about 10 seconds after injection.5. 2. phase b A gradually rising curve following phase a. It occurs during minute

6、s 2 through 4 and contains the peak of the curve. radioactivitytime(minutes)5. 3. phase c A decline curve after phase b. semiquantitative indextime to peak radioactivityTb5min half-time excretion C1/28min difference of peak radioactivity 30% difference of time to peak 1min radioactivitytime(minutes)

7、6、abnormal renography and its clinical applicationreasonprerenal：decrease of ERPFrenal：damage of renal functionpostrenal：urinary obstruction 6. persistent rising curve analysisclinical applicationa: normalb: persistent risingc: no declineurinary obstruction curve analysisa: normalb: straight lineno

8、demarcation between b and cclinical applicationlong-standing urinary obstruction causing renal function damageurinary obstruction after renal function damage for a long longation at a high level6.parabolic curve curve analysisa: normal/slight lowb: gradual risingc: gradual decliningTp delay

9、edclinical applicationacute incomplete obstruction of upper urinary tractmoderate impairment of renal functionhydronephrosis，renal longation at a low level curve analysisa: lowb: straight lineno demarcation between b and cclinical applicationsignificant renal damage acute renal failure

10、chronic complete obstruction of upper urinary tract with bad hydronephrosis curve analysisa: lowno b and cgradual decline after a appearingclinical applicationno function or poor functionrenal gressive decrease at a low level6.staircase decline curve analysisa: normalb: norma

11、lc: decline as irregular stairclinical applicationspasm of upper urinary tractpainmental tensionurinary tract infection6.unilateral small renography curve analysisOne side : normalSuffering side: a near-normal shape but the peak activity obvious decreased clinical applicationsignificant difference o

12、f function between the two kidneysstenosis of renal artery at one sidecongenital renal aplasia7、diuretic renography Diuretic renography is an important test to distinguish between obstructive hydronephrosis and non-obstructive dilatation.8. principleobstructive hydronephrosis (anatomic)non-obstructi

13、ve dilatation (functional)urinary stonestenosis of urinary tract ureteral reversevesicoureteral refluxurinary tract infection non-obstructive dilatationobstructive hydronephrosispyelectasispressure lowerthe rate of elimination of urine (agent) slowrising renogramusing a diureticpressure increasedpha

14、se c appearingrising renogramfunctionalanatomic method result8.2. method and resultfurosemide (0.5mg/Kg) injection at 20 min and test continued c phase appearing no or little change8.3. clincal applicationTo distinguish the obstructive reason is functional or anatomicLets look at some renographies from