Sibel UÇAK SEMİRGİN, Oktay YAPICI, Zeynep ÖZORMANCIK, Ayşen SEVER, Tarık BAŞOĞLU

Miksiyon Sonrası Görüntülerin Eklenmesi ile Elde Edilen Yeni Renogram Eğri Paterninin Obstrüktif Böbrek Patolojisi Tanısına Katkısı‡

A New Renogram Obtained by Adding Post-Micturation Images on the Diagnosis of Obstructive Uropathy The aim of this study was to evaluate the diagnostic input of the renal washout percentage and the extended renogram curve which was obtained by quantifying the data of post voiding dynamic images. Sixtysix kidneys of 54 patients (11 female and 43 male; age 1 month- 72 years ) with Tmax1/2 values >10 minutes (min) in the diuretric renography (group 1: Tmax1/2 > 20 min and group 2: Tmax1/2 between 10-20 min) were enrolled for the study. The kidneys in group 1 were also divided into 2 groups according to differential renal functions (group 1A >40%; group 1B 10% difference at split renal function during follow up. Obtaining the post-voiding images in a dynamic format allowed us to perform extended renogram and to calculate the renal washout percentages. Although the number of surgically diagnosed patient is not sufficient to get a definitive conclusion, the renal washout percentages and the extended renograms will contribute additional information in the diagnosis of obstructive uropathy. Çalışmadaki amacımız, miksiyon sonrası alınan dinamik görüntülerden elde edilen sayısal verilerle, uzatılmış bir renogram eğrisi elde etmek ve hesaplanan böbrek boşaltım yüzdesi ile birlikte sintigrafik tanıya katkısını değerlendirmektir. Tmaks1/2 değeri >10 dakika (dak.) olan (grup 1: Tmaks1/2 >20 dak ve grup 2: Tmaks1/2 10-20 dak) 54 hastaya (66 böbrek) 30 dakikalık dinamik çekim sonrası, aynı çekim parametrelerinde 2 dakikalık iki ek dinamik çekim alındı. İlk dinamik çekim (R30), miksiyon sonrası alınan birinci (Rek1) ve ikinci (Rek2) dinamik görüntülerden, zemin aktivitesi düzeltilmiş ve radyoaktif yarılanma formülü uygulanmış son böbrek sayımları elde edildi. Bu veriler kullanılarak bilgisayarda excell programında orijinal (R30) ve uzatılmış (Rek) renogram eğrileri ile böbrek boşaltım yüzdeleri (maksimum-minimum/maksimum aktivite) sırasıyla BY30, BYek1 ve BYek2 hesaplandı. Obstrüksiyon tanısında görsel değerlendirme bulguları ile böbreklerin boşaltım yüzde değerleri karşılaştırıldı. BY değeri 20 olan böbrekler, total fonksiyona katılım oranlarına göre gruplandırıldı-ğında, grup 1A (>%40)'da, 29 böbrekten 11'inde ve grup 1B (

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