Humans ; Liver Function Tests ; methods ; Technetium Tc 99m Aggregated Albumin ; Technetium Tc 99m Pentetate

OBJECTIVETo evaluate the accuracy of plasma clearance of iohexol (PCio) for glomerular filtration rate (GFR) measurement in Chinese children with chronic kidney disease (CKD) and assess the feasibility of single-blood-sample method or dried capillary blood spots in determining the PCio.

METHODSTotally 45 CKD children were included,in whom the (99m) Technetium-diethylenetriaminepentaacetic acid ((99m)Tc-DTPA) plasma clearance and iohexol plasma clearance were simultaneously determined. Blood samples were obtained 2,4,and 5 hours after injection. In addition, we also evaluated the efficacy of single blood sample method and dried blood spots method in iohexol plasma clearance.

RESULTSForty-five CKD children completed the iohexol plasma clearance and thirty-six children completed the (99m)Tc-DTPA plasma clearance at the same time among them. Thirteen children finished the iohexol dried blood spot clearance. The correlation coefficient between (99m)Tc-DTPA plasma clearance and iohexol plasma clearance was 0.941 and the bias was (6.53 ± 11.6) ml/ (min·1.73 m²), and the intraclass correlation coefficient (ICC) was high (ICC=0.947). The correlation between iohexol single-sample plasma clearance and double samples was also strong (r=0.958), with the bias being (4.26 ± 9.06)ml/(min·1.73 m²) and the ICC being 0.970. The iohexol clearance by dried blood spots showed a good correlation with the serum iohexol clearance (r=0.950), with the bias still being small [(0.48 ± 10.89)ml/(min·1.73 m²)].

CONCLUSIONSIohexol plasma clearance has satisfactory agreement with (99m)Tc-DTPA plasma clearance and can be used as an ideal method to measure GFR in CKD children. The single-sample method and dried blood spots method make iohexol plasma clearance more convenient and practical.

Child ; Glomerular Filtration Rate ; Humans ; Iohexol ; Renal Insufficiency, Chronic ; Technetium Tc 99m Pentetate

To evaluate the usefulness of brain SPECT as a tool with diagnostic and prognostic values m patients with acute cerebral infarction, twenty-four patients who were diagnosed as embolic(n=12) or thrombotic(n7-12) infarction by clinical manifestation and brain CT or MRI were selected. Both 99mTc-HMPAO & 99mTc-DTPA Brain SPECT were performed for each patients within 1 week after the attack Asymmetric index(Al) in both hemispheres was calculated as 200(l(right-left)l/(right+left)). Activities of daily livmg(ADL) was scored by Barthel Index on the admission day and the 21st day after the attack. The relationshiop between ADL index and Al of two types of brain SPECT was analysed by calculating correlation coefficient. 1.In embolic infarction, the Al of 99mTc-DTPA SPECT was markedly higher than that of 99mTc-HMPAO spect, but there was no difference in thrombotic type. 2. The AI of 99m'Tc-DTPA SPECT in embohc infarction was sigiuficantly higher than that m thrombotic type(p valu=.001), but the Al of 99mTc-HMPAO SPECT was similar in both types of infarction. 3.The correlation coefficient Al of 99mTc-DTPA Brain SPECT and ADL m the 21st day after stroke was statistically significated. These results suggested that the 99mTc-DTPA brain SPECT should be useful not only for the differemtial diagnosis between thrombotic and embolic infarctions but also for the prediction of prognosis in patients with ischemic stroke.
Activities of Daily Living ; Brain* ; Cerebral Infarction* ; Diagnosis* ; Humans ; Infarction ; Magnetic Resonance Imaging ; Prognosis* ; Stroke ; Technetium Tc 99m Exametazime ; Technetium Tc 99m Pentetate* ; Tomography, Emission-Computed, Single-Photon*

OBJECTIVETo study the relationship of renal aquaporin -1, -2, -3, and -4 (AQP1-4) expression with renal parenchymal thickness and glomerular filtration rate (GFR) in children with congenital hydronephrotis.

METHODSRenal tissue samples were obtained from 10 kidneys of 10 children (age: 62.3±18.3 months) with hydronephrosis and who underwent Anderson-Hynes pyeloplasty. Renal control samples were obtained from 6 children (age: 62.7±17.1 months) undergoing nephrectomy for nephroblastoma and were confirmed histologically as normal renal tissues. Renal parenchymal thickness of the hydronephrotic kidneys was measured by ultrasound preoperatively and was verified at operation. Renal GFR was assessed using 99mTc-DTPA scintigraphy preoperatively. Western blot was used to examine the expression of AQP1-4 in the renal tissues. The correlations of renal AQP1-4 expression with the renal parenchymal thickness and GFR were assessed by Pearson correlation analysis.

RESULTSThe expression of AQP1-4 in the hydronephrotis group was markedly reduced compared to that in the control group (P<0.05). The mean renal parenchymal thickness of the hydronephrotic kidney was 4.59±2.25 mm measured by ultrasound preoperatively. The mean GFR of the obstructed kidney was significantly lower than that of the contralateral kidney in the hydronephrosis group (40±12 mL/min vs 105±20 mL/min; P<0.05). The expression of AQP1, 2, 3 and 4 was positively correlated with preoperative renal GFR and renal parenchymal thickness in the hydronephrosis group (P<0.05). Renal parenchymal thickness was positively correlated with renal GFR (P<0.05).

CONCLUSIONSThe expression of renal AQP1-4 is reduced in children with congenital hydronephrosis. The expression levels of AQP1-4 are positively correlated with renal parenchymal thickness and GFR.

Aquaporins ; analysis ; Child ; Child, Preschool ; Female ; Glomerular Filtration Rate ; Humans ; Hydronephrosis ; congenital ; metabolism ; pathology ; Kidney ; pathology ; Male ; Sulfhydryl Compounds ; Technetium Tc 99m Aggregated Albumin ; Technetium Tc 99m Pentetate

PURPOSE: We measured pulmonary epithelial permeability by Tc-DTPA radioaerosol clearance in patients with diabetes and correlated with the presence of microangiopathy to understand the pathophysiology of pulmonary microangiopathy and evaluate Tc-DTPA radioaerosol clearance as a diagnostic test to assess pulmonary microangiopathy. MATERIALS AND METHODS: We performed ' Tc-DTPA radioaerosol scan in 10 normal subjects, 10 asym-ptomatic smokers, 20 diabetic patients without history of smoking (10 with microangiopathy, 10 without microangiopathy). Tc-DTPA clearance half-time (T1/2) was calculated, then compared with the result of chest radiography and pulmonary function test. RESULTS: Chest radiography and pulmonary function test were normal in all subjects. There were no significant difference of clinical or laboratory characteristics between these groups except age. The diabetic patients with micraangiopathy were significantly older (p<0.05). The T1/2of normal subjects and asyrnptomatic smokers were significantly different (65.2+23.7min vs 39.6+9.8min, p<0.05). For diabetic patients with microangiopathy, the T, was 90 5+46.5min and significantly delayed when compared with those of normals and asymptomatic smokers (p<0.05). However, the T1/2of diabetic patients without microangiopathy, 70.0+12.7 min, was not significantly different from those of normals or asyrnptomatic smokers (p>0.05). No significant correlation was found between the T1/2and spirometric parameters including DLcc>, FVC, FEV>, FEV(/FVC (%) and FEF)5-75g in all subjects, and between the T1/2 and duration of diabetes in diabetic patients. CONCLUSION: Eventhough the influence of age cant be excluded, delayed Tc-DTPA clearance half-time (T1/2)in diabetic patients with microangiopathy indicates decreased pulmonary cspillary permeability as one of the pathophysiologic results of pulmonary microangiopaththy. Further studies are needed in larger number of age matched control and diabetic patients to evaluate the diagnostic efficacy.
Diabetes Mellitus ; Diagnostic Tests, Routine ; Humans ; Permeability ; Radiography ; Respiratory Function Tests ; Smoke ; Smoking ; Technetium Tc 99m Pentetate ; Thorax

The glomerular filtration rate (GFR) is an important index of renal function with advantages of accurate, sensitive, stable, repetitive and accurate measurement of renal functions. The GFR is mainly determined in the clear rate of radioisotope markers (99m)Tc-DTPA, the process of which is complicated, long time-taking, high cost, and radioactively injuring. Recently, the methods using other renal function parameters measured easily to create the mathematic models and to estimate GFR are being investigated in the world. In this paper, for the renal function data of the Chinese, the efficiency in the three existing GFR formulas has been optimized with multi-function optimization techniques and the accuracy of the computation has been improved. Then the BP neural network technology is used for establishing a new GFR formula, which is a simpler form and obtains higher precision result than the formulas existed. The rmse and P30 of the new formula are better than those of the old ones.
Algorithms ; Creatinine ; blood ; Cystatin C ; blood ; Glomerular Filtration Rate ; Humans ; Models, Theoretical ; Neural Networks (Computer) ; Technetium Tc 99m Pentetate

OBJECTIVETo evaluate the effectiveness of dynamic SPECT (99m)Tc-galactosyl human serum albumin (GSA) scintigraphy on the assessment of reserve function of cirrhosis liver.

METHODSFrom January 2010 to December 2011, 55 patients with cirrhosis liver were enrolled in this study. The case numbers of male and female were 43 and 12 respectively and the age was (51 ± 9) years (ranging from 35 to 69 years). After routine biochemistry test, CT scan and (99m)Tc-GSA dynamic SPECT scan were performed in turn using a juxtaposed SPECT/CT system. Then the morphologic volume of liver parenchyma (MLV), functional liver volume (FLV) and the hepatic cell absorption rate constant (GSA-K) were calculated. The correlations between GSA-K and routine biochemistry test, Child-Pugh score, indocyanine green clearance rate (ICG-K) were analyzed. The patients were further divided into 3 groups according to whether there was occlusion or stenosis in the main branch of left portal vein (group 1, n = 5), right portal vein (group 2, n = 13) or not (group 3, n = 37) and the regional hepatic functions index of the 3 groups were compared.

RESULTSThe value of FLV of the whole, left and right liver was (594 ± 152) ml, (244 ± 119) ml and (356 ± 171) ml, respectively. There were correlations between GSA-K and total bilirubin, prothrombintime, Child-Pugh score and ICG-K (r = -0.730--0.298, P < 0.05). The FLV and MLV ratios of involved hemiliver to uninvolved hemiliver were 0.09 ± 0.06 and 0.30 ± 0.14 in group 1, 0.57 ± 0.43 and 1.08 ± 0.63 in group 2, 0.71 ± 0.30 and 0.71 ± 0.48 in group 3. The difference in MLV-FLV ratio was signifcant between group 1 and group 3, between group 2 and group 3 (P = 0.000).

CONCLUSIONSThe dynamic SPCECT (99m)Tc-GSA scintigraphy can not only assess the whole liver function of cirrhosis liver effectively, but also evaluate the variation of regional liver function accurately.

Adult ; Aged ; Female ; Humans ; Liver ; physiopathology ; Liver Cirrhosis ; physiopathology ; Liver Function Tests ; Male ; Middle Aged ; Technetium Tc 99m Aggregated Albumin ; metabolism ; Technetium Tc 99m Pentetate ; metabolism ; Tomography, Emission-Computed, Single-Photon

To compare diagnostic value of 4 kinds of target-to-nontarget ratio (T/NT), and to choose a better one to assess thyroid associated ophthalmopathy (TAO) activity.
 Methods: The clinical data were collected for 29 newly-diagnosed patients (58 eyes) with TAO who underwent orbital 99mTc-DTPA single photon emission computed tomography/computed tomography (SPECT/CT) fusion images according to the clinical activity score (CAS). They were divided into an active group (18 cases, 36 eyes), an inactive group (11 cases, 22 eyes), and a control group (9 cases, 18 eyes). Diagnostic value of orbital/occipital lobe radioactive uptake count ratio (T/NT1), orbital/occipital radioactive uptake count ratio (T/NT2), orbital/thalamus radioactive uptake count ratio (T/NT3), and orbital/cerebellar radioactivity uptake count ratio (T/NT4) were calculated, and the CAS of Spearman rank correlation and receiver operating characteristic (ROC) curve were analyzed.
 Results: T/NT1, T/NT2 and CAS were correlated (r1=0.873, r2=0.527; P<0.001), with the better correlation between T/NT1 and CAS and there was no correlation between T/NT3, T/NT4 and CAS (r3=0.039, r4=0.090; P>0.05). Area under the ROC curve of T/NT1 was 0.860, area under the ROC curve of T/NT2 was 0.581, and the accuracy for T/NT1 on TAO activity was good. T/NT1=9.74 could be used as active threshold for judge of TAO in patients.
 Conclusion: There is a good correlation between T/NT1 and CAS. TAO activity assessment possesses high diagnostic value, and SPECT/CT together with imaging anatomical location is more accurate.
Case-Control Studies ; Graves Ophthalmopathy ; diagnostic imaging ; Humans ; Orbit ; diagnostic imaging ; ROC Curve ; Radiopharmaceuticals ; Statistics, Nonparametric ; Technetium Tc 99m Pentetate ; Tomography, Emission-Computed, Single-Photon ; methods

OBJECTIVETo investigate the role and clinical value of radionuclide imaging in hepatic impact injuries in rabbits.

METHODSRabbits were experimentally impacted on the liver with BIM-IV bio-impact machine. Liver imaging was performed with 99mTc labeled sodium phytate. Liver blood pool imaging was performed with 99mTc-stannous pyrophosphate labeled red blood cells. The results of radionuclide imaging were compared with the anatomic results.

RESULTSThere was significant difference between the images of the injured liver and the control. Radio diminution and defect were shown in the injured liver areas. Various sorts of abnormal radioactivity distribution were observed with hepatic blood pool imaging. The results of the liver imaging and liver blood pool imaging were accorded with the results of the anatomic findings.

CONCLUSIONSRadionuclide imaging may well display the changes of hepatocellular structures and functions after injury, which is valuable in locating the concrete injured position and differentiating the injured degrees of liver.

Animals ; Disease Models, Animal ; Female ; Injury Severity Score ; Liver ; diagnostic imaging ; injuries ; Male ; Rabbits ; Radionuclide Imaging ; Sensitivity and Specificity ; Technetium Tc 99m Pentetate ; Wounds and Injuries ; diagnostic imaging

OBJECTIVETo identify the uptake and biological distribution of technetium galactosyl human serum albumin diethylenetriamine pentaacetic acid injection (99mTc-GSA) in three mouse models with different degrees of hepatic injuries.

METHODSThree mouse models including hepatic fibrosis, hepatic cholestasis, and liver cancer were established. Hepatic fibrosis model was established by intraperitoneal injection of carbon tetrachloride, 0.4 ml 10%, every 48 hours for 48 days. Hepatic cholestasis model was set up by ligature of the common bile duct for 72 hours, and liver cancer model by implantation of H22 tumor cells underneath liver capsule for 10 days. On measurement, each mouse in different models and normal controls was injected with 0.1 ml (0.37 MBq)99mTc-GSA (2 microg) into vena caudalis, and 5 minutes later sacrificed by decapitation. Important organs and tissues including liver, heart, lungs, kidney, spleen, stomach, blood, bones, muscles, and intestines were taken and their different radio countings were measured. The hepatic injuries were evaluated with serum and pathological examinations.

RESULTS99mTc-GSA was concentrated in the liver in all three models and the control mice ( >40% ID x g(-1)). Compared with the control mice (90.05 +/- 10.55)% ID x g(-1), the density of 99mTc-GSA was significantly lower in the models with hepatic injuries (P < 0.001). The liver function test indicated that the injury in hepatic fibrosis model was less serious than those in the other two models. However, the concentration of 99mTc-GSA in hepatic fibrosis model [(72.20 +/- 2.13)% ID x g(-1)] was significantly higher than those in the models with cholestasis [(56.72 +/- 5.92)% ID x g(-1)] and liver cancer [(42.80 +/- 6.05)% ID x g(-1)] (P < 0.001).

CONCLUSIONS99mTc-GSA may well concentrate in liver and its concentration degree is adversely correlated with hepatic injuries. Therefore 99mTc-GSA may be clinically used as liver imaging agent. When combined with three-dimensional scanning technique, it may facilitate constructing a new three-dimensional imaging method to demonstrate the function of designed liver segments.

Animals ; Disease Models, Animal ; Female ; Humans ; Liver ; diagnostic imaging ; drug effects ; injuries ; Liver Diseases ; diagnosis ; diagnostic imaging ; Mice ; Mice, Inbred BALB C ; Radiography ; Radionuclide Imaging ; Radiopharmaceuticals ; administration & dosage ; pharmacokinetics ; Random Allocation ; Technetium Tc 99m Aggregated Albumin ; administration & dosage ; pharmacokinetics ; Technetium Tc 99m Pentetate ; administration & dosage ; pharmacokinetics