title: A physiologic approach to renal scintigraphy. Application to evaluation of hypertension.
abstract: The aim of this study was to define the use of the triple radiopharmaceutical renal study (TRRS) for renal scintigraphy as a physiological tool for renal evaluation, and to determine if the sensitivity and/or specificity of a renal study for the diagnosis of renovascular hypertension (RVH) could be improved by the combination of three radiopharmaceuticals (i.e., I-131 OIH, Tc-99m DTPA, and Tc-99m glucoheptonate). One hundred ninety-five patients with suspected RVH underwent TRRS, standard Tc-99m DTPA renal studies, and renal angiography. One hundred eighty-nine patients were hypertensive and ischemic nephropathy was suspected in six. Ninety-one, including three patients with ischemic nephropathy, had a renal artery stenosis of 70% or more (66 unilateral, 25 bilateral). Effective renal plasma flow (ERPF), glomerular filtration rate (GFR) (from plasma clearance of I-131 OIH and Tc-99m DTPA), and geometric renal masses (from Tc-99m glucoheptonate study) were compared to normal values corrected for body surface, to determine the severity of renal dysfunction. For the TRSS, RVH criteria included: 1) differential Tc-99m DTPA function minus differential Tc-99m glucoheptonate function of affected kidney ( < -5% or > 5%) and 2) functional parameters: ERPF = 1.6-2.0 ml/g/minute, GFR = 0.25-0.4 ml/g/minute, and filtration fraction (i.e., GFR/ERPF = 0.15-0.20) on the affected side.
authors.affiliation: Department of Nuclear Medicine, Hospital Hôtel-Dieu de Montréal, Université de Montréal, Québec, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Turpin
authors.forename: R
authors.initials: R
authors.lastname: Lambert
authors.forename: A
authors.initials: A
authors.lastname: Milot
authors.forename: R
authors.initials: R
authors.lastname: Taillefer
authors.forename: J
authors.initials: J
authors.lastname: Leveille
authors.forename: B
authors.initials: B
authors.lastname: Lefebvre
mesh_terms: D000368:Aged; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging* / Q000453:epidemiology; D007457:Iodine Radioisotopes; D007465:Iodohippuric Acid; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D011237:Predictive Value of Tests; D015995:Prevalence; D011859:Radiography; D011866:Radioisotope Renography / Q000379:methods*; D012077:Renal Artery / Q000000981:diagnostic imaging; D017596:Renal Plasma Flow, Effective / Q000502:physiology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013400:Sugar Acids; D016284:Technetium Tc 99m Pentetate
chemical_list: D007457:Iodine Radioisotopes; D015609:Organotechnetium Compounds; D013400:Sugar Acids; D007465:Iodohippuric Acid; C100014:technetium Tc 99m gluceptate; D016284:Technetium Tc 99m Pentetate