203Hg-Neohydrinによる,腎scintigram及び腎摂取率の研究 第II篇: 腎scigtigramの臨床

Abstract

Renal scintigram with 2031-Ig-Neohydrinw as performed o n 139 patients (145 cases) with renal diseases who visited the Department of Urology at Kyoto University. The results obtained are summarized as follows. 1) It was noted that a trend of faint depiction of the bilateral lower poles of kidney and a overlap of hepatic uptake on the upper pole if the right kidney are noteworthy in scintigram of normal kidneys. In addition, an increase of hepatic uptake in the case of total renal hypcfunction remarkably affected to the renal scintigram. Normal pattern was demonstrated in the cases of idiopathic renal bleeding. 2) In 8 cases of unilateral renal hyperten s ion out of 32 cases of patients with hypertension, in which various examinations were performed for determination of the unilaterality, it was confirmed that the renal scintigram has advantages on simplicity and reliability. This method was especially useful in the case of segmental ischemia where the diagnosis is difficult by means of other tests. 3) The approximate s ize of intrinsic renal mass, detectable with the scintigram, located in the peripheral and central parts of the kidney was found experimentally to be as small defect as 2 cm and 3 cm diameters respectively, even though these figures vary with the local relation to the renal parenchym. 4) A diagnostic s i gnificance of renal scintigram was clarified in the cases of congenital abnormalities of the shape and localization of the kidney. 5) In renal tuberculosis, where partial defects are not infreqUently seen, the functional surviving areas were more clearly demonstrated by means of renal scintigraphy than IVP or RP. This will give a useful reference for the surgical procedure of partial resection. 6) In patients with pyelonephritis, a normal pattern of renal scintigram was seen in acute period while more or less decreased uptake was shown in chronic period. In generally, the decrease was not localized but diffuse in the most instances. In cases of hydronephrosis, lower uptake was demonstrated in renal scintigram. Severe cases, in addition, showed no depiction at all. However, presence of latent function of the kidney seemed unable to be elucidated with the finding of the scintigram. 8) No specific pattern but lowering of uptake in accordance w i th functional disturbances was demonstrated in renal scintigram in patients with renolithiasis. 9) Following surgical operation of the kidney, ren a l scintigram showed defects being reflected the procedures. An unexpectedly prolonged decrease in the renal uptake of 203Hg was seen following procedure of hemostasis at the operation. 10) The reproducibility of renal scintigram w i th 203Hg-Neohydrin was studied and illustrated. All instances showed good results. 11) Advantages as well as disadva n tages of renal scintigram with 203Hg-Neohydrin were presented and the discussion was made on views of improvement.