Renal SPECT/CT Imaging
Value of 99Tcm-DMSA renal SPECT/CT imaging in the diagnosis of upper urinary tract infection in adults
Chen Congxia, Wang Haitao, Chen Min, Yao Zhiming, Guo Yue, Li Xu
Published 2020-07-25
Cite as Chin J Nucl Med Mol Imaging, 2020, 40(7): 394-398. DOI: 10.3760/cma.j.cn321828-20200318-00112
Abstract
ObjectiveTo explore the diagnostic value of 99Tcm-dimercaptosuccinic acid (DMSA) renal SPECT/CT imaging in adult upper urinary tract infection.
MethodsFrom September 2017 to December 2019, 99Tcm-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 99Tcm-DMSA renal SPECT/CT imaging was analyzed and compared with that of 99Tcm-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.
ResultsOf 109 patients, 91 were diagnosed as upper urinary tract infection by 99Tcm-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).
Conclusions99Tcm-DMSA renal SPECT/CT has good clinical value in the diagnosis of adult upper urinary tract infection. Compared with 99Tcm-DMSA renal SPECT, 99Tcm-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.
Key words:
Urinary tract infections; Technetium Tc 99m dimercaptosuccinic acid; Tomography, emission-computed, single-photon; Tomography, X-ray computed
Contributor Information
Chen Congxia
Peking University Fifth School of Clinical Medicine
Department of Nuclear Medicine, Beijing Hospital, National Center of Gerontology
Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
Wang Haitao
Department of Nephrology, Beijing Hospital, National Center of Gerontology
Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
Chen Min
Department of Radiology, Beijing Hospital, National Center of Gerontology
Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
Yao Zhiming
Peking University Fifth School of Clinical Medicine
Department of Nuclear Medicine, Beijing Hospital, National Center of Gerontology
Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
Guo Yue
Peking University Fifth School of Clinical Medicine
Department of Nuclear Medicine, Beijing Hospital, National Center of Gerontology
Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
Li Xu
Peking University Fifth School of Clinical Medicine
Department of Nuclear Medicine, Beijing Hospital, National Center of Gerontology
Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
