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Value of Gallium-67 Inflammatory Scan in Investigation of Acute Pyelonephritis in Pediatric Patient

鎵—67炎癥造影在小兒急性腎盂腎炎輔助診斷之價值

摘要


本例為一兩歲大的幼童,因泌尿道感染而至本院求診,在診斷確立後按常規進行鎝-99m-DMSA腎臟造影以確認是否併發急性腎孟腎炎。由鎝─99m─DMSA腎臟造影的影像中,明確發現左腎的下半部有急性發炎所導致的灌注缺損。此外,左腎的位置也較常見所在的位置低:之後進行鎵-67發炎造影以區分左腎的下半部為發炎或結痂的病灶,意外發現其左腎是位於正常的解剖位置,主因於腎臟上端也處於發炎狀態,因其停止分佈鎝─99m DMSA而造成誤判。其後以鎵-67配合鎝─99m─DMSA作為患者追蹤,成效十分良好。由於鎵-67炎症造影之結果改變了先前的診斷,也因其對於病灶範圍的重新定位,對臨床的治療產生正面的助益。本例的經驗中發現,對於懷疑急性腎孟腎炎的患者,除鎝─99m─DMSA的檢查外,配合鎵-67作為急性發炎與結痂組織之鑑別診斷有其臨床應用之價值。

並列摘要


We report a case of urinary tract infection. 99mTc-DMSA renal scan was performed and revealed perfusion defects of the lower portion of left kidney. For the differentiation acute pyelonephritis from scar formation, 67Ga inflammatory scan was acquired. Incidentally, we found that more acute and advanced inflammation involvement not only associated with the lower portion but also the upper pole of left kidney. We revised our previous diagnostic impression from 99mTc-DMSA renal scan after reviewed this patient’s 67Ga inflammatory image. Accordingly, we though that 67Ga inflammatory scan can be a useful diagnostic tool in the early investigation of children renal infection.

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