PURPOSE: This study aimed to determine the diagnostic value of the relative filtration fraction (RFF) assessed by dynamic 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA) renal scintigraphy after angiotensin-converting enzyme (ACE) inhibition for renovascular hypertension (RVHT) diagnosis. METHODS: 99mTc-DTPA captopril renal scintigraphy performed in adolescents or adults (≥ 10 years) with suspected RVHT was retrospectively reviewed. The RFF of the affected kidney was qualitatively assessed as the relative glomerular filtration rate during the 2 to 3-min period compared with the relative perfusion during the first 60 s (qualitative RFF) and scored from 1 (definitely same) to 5 (definitely decreased). The quantitative RFF of the affected kidney was obtained by dividing the percentage of glomerular filtration rate by the percentage of renal perfusion. RESULTS: Overall, 173 patients (high probability, n = 15; and low probability, n = 158) were included based on conventional captopril renal scintigraphic criteria. An abnormal qualitative RFF was observed in 12 patients with high probability, and the diagnostic sensitivity was 80.0% (95% CI, 51.9-95.7). The RFF was normal in 152 patients with low probability, and the diagnostic specificity was 96.2% (95% CI, 91.9-98.6). The RFF was lower in patients with high probability than in those with low probability (0.79 ± 0.15 vs. 1.02 ± 0.11, P < 0.0001). CONCLUSIONS: The RFF assessed by dynamic 99mTc-DTPA renal scintigraphy after ACE inhibition can detect patients with high probability for RVHT. The RFF after ACE inhibition might be a useful diagnostic criterion especially when baseline scintigraphy is not available for evaluating ACE inhibition-induced changes.
PURPOSE: This study aimed to determine the diagnostic value of the relative filtration fraction (RFF) assessed by dynamic 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA) renal scintigraphy after angiotensin-converting enzyme (ACE) inhibition for renovascular hypertension (RVHT) diagnosis. METHODS: 99mTc-DTPA captopril renal scintigraphy performed in adolescents or adults (≥ 10 years) with suspected RVHT was retrospectively reviewed. The RFF of the affected kidney was qualitatively assessed as the relative glomerular filtration rate during the 2 to 3-min period compared with the relative perfusion during the first 60 s (qualitative RFF) and scored from 1 (definitely same) to 5 (definitely decreased). The quantitative RFF of the affected kidney was obtained by dividing the percentage of glomerular filtration rate by the percentage of renal perfusion. RESULTS: Overall, 173 patients (high probability, n = 15; and low probability, n = 158) were included based on conventional captopril renal scintigraphic criteria. An abnormal qualitative RFF was observed in 12 patients with high probability, and the diagnostic sensitivity was 80.0% (95% CI, 51.9-95.7). The RFF was normal in 152 patients with low probability, and the diagnostic specificity was 96.2% (95% CI, 91.9-98.6). The RFF was lower in patients with high probability than in those with low probability (0.79 ± 0.15 vs. 1.02 ± 0.11, P < 0.0001). CONCLUSIONS: The RFF assessed by dynamic 99mTc-DTPA renal scintigraphy after ACE inhibition can detect patients with high probability for RVHT. The RFF after ACE inhibition might be a useful diagnostic criterion especially when baseline scintigraphy is not available for evaluating ACE inhibition-induced changes.
Authors: Keith Wheatley; Natalie Ives; Richard Gray; Philip A Kalra; Jonathan G Moss; Colin Baigent; Susan Carr; Nicholas Chalmers; David Eadington; George Hamilton; Graham Lipkin; Anthony Nicholson; John Scoble Journal: N Engl J Med Date: 2009-11-12 Impact factor: 91.245
Authors: M Dondi; S Fanti; A De Fabritiis; A Zuccala; R Gaggi; M Mirelli; A Stella; M Marengo; F Losinno; N Monetti Journal: J Nucl Med Date: 1992-11 Impact factor: 10.057
Authors: Kimberley J Hansen; Matthew S Edwards; Timothy E Craven; Gregory S Cherr; Sharon A Jackson; Richard G Appel; Gregory L Burke; Richard H Dean Journal: J Vasc Surg Date: 2002-09 Impact factor: 4.268
Authors: Liesbeth Bax; Arend-Jan J Woittiez; Hans J Kouwenberg; Willem P T M Mali; Erik Buskens; Frederik J A Beek; Branko Braam; Frans T M Huysmans; Leo J Schultze Kool; Matthieu J C M Rutten; Cornelius J Doorenbos; Johannes C N M Aarts; Ton J Rabelink; Pierre-François Plouin; Alain Raynaud; Gert A van Montfrans; Jim A Reekers; Anton H van den Meiracker; Peter M T Pattynama; Peter J G van de Ven; Dammis Vroegindeweij; Abraham A Kroon; Michiel W de Haan; Cornelis T Postma; Jaap J Beutler Journal: Ann Intern Med Date: 2009-05-04 Impact factor: 25.391