A new radioisotopic method of determining the separate glomerular clearance of the kidneys is described. After injection of 99mTc-DTPA, the data from a scintillation camera are recorded by computer. The renal curves are corrected for extrarenal activity and the plasma curve is obtained from a precordial curve. At each instant the slope of the renal curve divided by the corresponding plasma concentration gives the separate clearance value, in the period extending from 80 to 180 s after injection of the tracer. The error and correction factors introduced are discussed. Normal values are established on 25 patients and correspond to inulin clearance values. Left kidney: 60 ml/min (SD=13). Right kidney: 57 ml/min (SD=12). The method is simple for the patient, takes only 20 min, is not dangerous, is particularly applicable to young children and can be repeated frequently in the same patient.
An international project was set up to study the clinical usefulness of intrarenal transit times derived from the renogram by deconvolution. A common data sheet, to collect clinical, biochemical, radiological and isotopic information, was completed by the centres. Five hundred and ninety-one patients were studied and the results analysed. The mean transit time (MTT) in normal kidneys was found to be 3.6 +/- 1.1 min. If the MTT is greater than 7.6 min, a kidney is likely to be obstructed. In vesico-ureteric reflux, the transit times are prolonged, but they are normal in infection, hypertension, parenchymal disease and minimally irradiated kidneys. In transplantation, when the kidney is normal, the transit times are shorter than in the natural kidney; in acute rejection, transit time are prolonged.
The aim of this work was to compare the advantages and the limitations of several data processing techniques for the assessment of esophageal transit. The following qualitative methods were evaluated: scintigraphic image, cine-display, regional time-activity curve, and condensed image. The quantitative methods evaluated were the pixel to pixel presentation of parameters of the time-activity curves such as time of arrival, time to maximum, and several downslope parameters, mean transit time, mean time, and a new transit parameter based on the radioactive decay. The study allowed us to conclude that for the detection and the quantitation of esophageal transit the method of choice was the combined use of the condensed image and the pixel to pixel mean time image. The parametric image using the transit parameter calculated from decay was shown as a valuable alternative if an ultra-short half-life radionuclide was used as the tracer.
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