Value of the Filtration Fraction Assessed by Dynamic ⁹⁹mTc-Diethylenetriaminepentaacetic Acid Renal Scintigraphy After Angiotensin-Converting Enzyme Inhibition for the Diagnosis of Renovascular Hypertension
10.1007/s13139-019-00595-w
- Author:
Eonwoo SHIN
1
;
Changhwan SUNG
;
Hye Joo SON
;
Dong Yun LEE
;
Sun Young CHAE
;
Dae Hyuk MOON
Author Information
1. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympicro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea. dhmoon@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
⁹⁹mTc-diethylenetriaminepentaacetic acid renal scintigraphy;
Angiotensin-converting enzyme inhibition;
Renovascular hypertension;
Filtration fraction
- MeSH:
Adolescent;
Adult;
Captopril;
Diagnosis;
Filtration;
Glomerular Filtration Rate;
Humans;
Hypertension, Renovascular;
Kidney;
Perfusion;
Radionuclide Imaging;
Retrospective Studies;
Sensitivity and Specificity
- From:Korean Journal of Nuclear Medicine
2019;53(4):270-277
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study aimed to determine the diagnostic value of the relative filtration fraction (RFF) assessed by dynamic ⁹⁹mTc-diethylenetriaminepentaacetic acid (⁹⁹mTc-DTPA) renal scintigraphy after angiotensin-converting enzyme (ACE) inhibition for renovascular hypertension (RVHT) diagnosis.METHODS: ⁹⁹mTc-DTPA captopril renal scintigraphy performed in adolescents or adults (≥ 10 years) with suspected RVHT was retrospectively reviewed. The RFF of the affected kidney was qualitatively assessed as the relative glomerular filtration rate during the 2 to 3-min period compared with the relative perfusion during the first 60 s (qualitative RFF) and scored from 1 (definitely same) to 5 (definitely decreased). The quantitative RFF of the affected kidney was obtained by dividing the percentage of glomerular filtration rate by the percentage of renal perfusion.RESULTS: Overall, 173 patients (high probability, n = 15; and low probability, n = 158) were included based on conventional captopril renal scintigraphic criteria. An abnormal qualitative RFF was observed in 12 patients with high probability, and the diagnostic sensitivity was 80.0% (95% CI, 51.9–95.7). The RFF was normal in 152 patients with low probability, and the diagnostic specificity was 96.2% (95% CI, 91.9–98.6). The RFF was lower in patients with high probability than in those with low probability (0.79 ± 0.15 vs. 1.02 ± 0.11, P < 0.0001).CONCLUSIONS: The RFF assessed by dynamic ⁹⁹mTc-DTPA renal scintigraphy after ACE inhibition can detect patients with high probability for RVHT. The RFF after ACE inhibition might be a useful diagnostic criterion especially when baseline scintigraphy is not available for evaluating ACE inhibition-induced changes.
