The diagnosis of renovascular hypertension with technetium-99m-ethylenedicysteine captopril scintigraphy.
OBJECTIVE
The authors present preliminary findings on the diagnosis of renovascular hypertension with technetium-99m-ethylenedicysteine (99mTc-EC).


METHODS
Thirty-nine patients referred to the nuclear medicine department with clinical evidence of renovascular hypertension were included in the study. Baseline and captopril scintigraphies were done on separate days after the injection of 185 MBq of 99mTc-EC. All patients had angiographic correlation and 9 patients were shown to have renal artery stenosis.


RESULTS
Quantitative analysis of the data showed no significant changes of perfusion index (PI), split renal function (SRF), and effective renal plasma flow (ERPF) values between pre- and postcaptopril studies in patients with significant renal artery stenosis (P > 0.05). Baseline and postcaptopril values for PI, SRF, and ERPF were measured as 128 +/- 21 and 116 +/- 12 mL/minute, 47 +/- 1 and 50 +/- 2 mL/minute, and 250 +/- 18 and 231 +/- 20 mL/minute, respectively. However, time to maximum activity (Tmax), time to half maximum activity (T 1/2), time to two thirds of maximum activity (T 2/3), and residual cortical activity (RCA) values showed marked changes with a rising renogram curve (P < 0.05). Baseline and postcaptopril values for Tmax, T 1/2, T 2/3, and RCA were measured as 3.1 +/- 0.1 and 20.2 +/- 1 minute, 5.4 +/- 0.4 and 45.4 +/- 3.1 minutes, 3.1 +/- 0.2 and 33.7 +/- 4.1 minutes, and 27 +/- 4 and 215 +/- 34 minutes, respectively. All scintigraphic studies showed good correlation with angiography and no false-positive or false-negative results were observed.


CONCLUSIONS
This preliminary study demonstrates that 99mTc-EC has good potential for the diagnosis of renovascular hypertension and that a single diagnostic criteria, specifically a rising renogram curve, seems adequate. However, the authors' initial results should be confirmed in a broader patient population.
Ugur
O
O
Department of Nuclear Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Caner
B
B
Cekirge
S
S
Balkanci
F
F
Ergün
E L
EL
Kostakoglu
L
L
Bekdik
C
C
D000293:Adolescent; D000328:Adult; D000792:Angiography; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002216:Captopril / Q000627:therapeutic use*; D003545:Cysteine / Q000031:analogs & derivatives*; D005260:Female; D006207:Half-Life; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging* / Q000188:drug therapy; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology; D007672:Kidney Cortex / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging; D012079:Renal Circulation / Q000187:drug effects; D017596:Renal Plasma Flow, Effective / Q000187:drug effects
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D015609:Organotechnetium Compounds; C073806:technetium Tc 99m-ethylenedicysteine; D002216:Captopril; D003545:Cysteine