First pass renal scintigraphy in patients with renal hypertension and diabetes

2034 Objectives Quantitative evaluation of renal parameters in patients with hypertension and diabetes determined from [99m ]Tc- pertechnetate renal angioscintigraphy. Study consisted of 93 patients (pts), both genders between 18-80 years divided in four groups. Out of them 32 pts (group A) were controls, 48 were with hypertension (group B), 13 pts with hypertension and diabetes (group C). Among pts with hypertension there were 10 pts with suspicion on renovascular hypertension (group D). Methods First pass renal scintigraphy was performed in all patients with gamma camera, in posterior view after bolus administration 740 MBq[99m ] Tc pertechnetate, images were acquired in 0,5 second frames for one minute. Time- activity curves were generated from regions of interest (ROIs) manually placed over region of aorta and kidneys. We examined three renal parameters determined from ROIs including: renal perfusion index (RPI) derived from peak counts for both kidneys and for aorta; renal perfusion area (RPA) acquired by determination of pixel size area in cm2 of kidneys ROIs and time delay in seconds (T1) between renal and aortic curves in initial part of the curves. Results Mean values of RPI, RPA, T1 for group A amounts as follows 1,3±0,4; 55,68±5; 0,6±0,2; for group B 0,90±0,16; 49,11±2; 1,6±0,5; for group C 0,77±0,11; 40,84±5; 2,13±0,3. Mean unilateral values of RPI, RPA, T1 for group D 0,60±0,12; 45,63±5; 3,45±0,5; contra-lateral value 11±0,3; 52,11±5; 1,5±0,6. Conclusions First pass renal scinitigraphy is noninvasive method which allows accuracy and reproducibility in assessing and distinguishing whether there are dominant changes in large renal arteries or in renal parenchyma. We can conclude that hypertension changes of renal parenchyma are characterized by symmetrical lower RPI and RPA values and with T1 lower than 2 sec but renovascular hypertension by unilateral T1 value more than 2 sec as well as with lower RPI and RPA. Finally, patients who have lower RPI and RPA as well as higher T1 have worse prognosis than patients who have disturbance only in one parameter.