Value of 99Tc m-DMSA renal SPECT/CT imaging in the diagnosis of upper urinary tract infection in adults
10.3760/cma.j.cn321828-20200318-00112
- VernacularTitle:99Tc m－DMSA肾SPECT/CT显像诊断成人上尿路感染的价值
- Author:
Congxia CHEN
1
;
Haitao WANG
;
Min CHEN
;
Zhiming YAO
;
Yue GUO
;
Xu LI
Author Information
1. 北京大学第五临床医学院、北京医院核医学科、国家老年医学中心、中国医学科学院老年医学研究所 100730
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2020;40(7):394-398
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the diagnostic value of 99Tc m-dimercaptosuccinic acid (DMSA) renal SPECT/CT imaging in adult upper urinary tract infection. Methods:From September 2017 to December 2019, 99Tc m-DMSA renal SPECT/CT imaging and clinical data of 109 patients (14 males, 95 females; age: 23-85(60.0±14.1) years) suspected of upper urinary tract infection from Beijing Hospital were retrospectively analyzed. Final clinical diagnosis was regarded as the diagnostic standard. The diagnostic efficacy of 99Tc m-DMSA renal SPECT/CT imaging was analyzed and compared with that of 99Tc m-DMSA renal SPECT imaging. The imaging features of SPECT/CT imaging in upper urinary tract infection were analyzed. The differences between the diagnostic methods were analyzed by using χ2 test or Fisher′s exact test. Results:Of 109 patients, 91 were diagnosed as upper urinary tract infection by 99Tc m-DMSA renal SPECT/CT imaging, with the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 100%(86/86), 78.26%(18/23), 94.51%(86/91), 18/18 and 95.41%(104/109), respectively. With the application of low-dose CT, the diagnostic specificity of SPECT/CT was significantly higher than that of SPECT (52.17% (12/23); P=0.014), and the causes of upper urinary tract infection were found in 5.81% (5/86) of patients with the help of CT. There were 10 (29.41%, 10/34) patients with chronic pyelonephritis had typical signs of renal scar on SPECT/CT imaging. Excluding the patients with typical renal scar, 11.54% (6/52) and 37.50% (9/24) of patients with acute and chronic pyelonephritis had decrease or defect focus≤2 ( χ2=6.987, P=0.008). Conclusions:99Tc m-DMSA renal SPECT/CT has good clinical value in the diagnosis of adult upper urinary tract infection. Compared with 99Tc m-DMSA renal SPECT, 99Tc m-DMSA renal SPECT/CT can effectively improve the diagnostic specificity and explore the causes of upper urinary tract infection such as urinary tract obstruction and stones.
