Renal uptake of Tl-201 in hypertensive patients undergoing myocardial perfusion imaging.
The detection of renovascular disease (RVD) has particular relevance in hypertensive patients (HP) who have symptoms of target organ damage. To evaluate the possibility of RVD in HP undergoing myocardial perfusion scintigraphy for chest pain symptoms, posterior renal images were obtained at 1-3 hours after Tl-201 injection. Analog and computer images were obtained for 5 minutes in 45 HP; 12 patients with no history of hypertension or renal disease served as normal controls. For qualitative analysis, images were coded and read by three observers as to symmetry of renal uptake. Differential renal uptake of Tl-201 (DRU) was quantitated on computer images. In normal controls, uptake was agreed on as symmetric. In HP, 6 patients had marked asymmetry of DRU and 4 had possibly significant asymmetry; 2 had decreased uptake in both kidneys suggesting bilateral RVD or nephrosclerosis. Objective correlation with DRU was obtained in 10 HP who had contrast angiography, confirming 4 cases of unilateral RVD and 2 of bilateral RVD. Thirteen patients also had renography with Tc-99m DTPA; differential renal function by this modality correlated well with DRU of Tl-201 (r = 0.98). Thus, DRU of Tl-201 can be used as a supplement to myocardial scintigraphy to identify HP who require further evaluation and treatment of RVD.
Hurwitz
G A
GA
Department of Diagnostic Radiology/Nuclear Medicine, University of Western Ontario, London, Canada.
Mattar
A G
AG
Bhargava
R
R
Driedger
A A
AA
Hogendoorn
P
P
Wesolowski
C A
CA
D000328:Adult; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D006973:Hypertension / Q000150:complications; D006978:Hypertension, Renovascular / Q000150:complications / Q000000981:diagnostic imaging*; D007511:Ischemia / Q000000981:diagnostic imaging; D007668:Kidney / Q000098:blood supply / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D004369:Pentetic Acid; D011877:Radionuclide Imaging; D012039:Regional Blood Flow; D016284:Technetium Tc 99m Pentetate; D013794:Thallium Radioisotopes
D015609:Organotechnetium Compounds; D013794:Thallium Radioisotopes; D004369:Pentetic Acid; D016284:Technetium Tc 99m Pentetate