자궁경부암 50예를 대상으로 방사선치료전에 정맥성 신우조형술과 renogram을 시행하고 방사선 치료후 환자의 추적검사로써 renogram을 일정한 간격으로 시행한 후 그 결과를 비교 분석하여 다음과 같은 소견을 얻었다. 1) 방사선치료전 정맥성 신우조형술에서 비정상소견을 나타낸 환자는 28.8%였고 이중 stage Ⅲ와 Ⅳ인 예가 대부분이었으며 주로 수장증형(hydronephrosis pattern)과 무기능형(Non-visualization)이었다. 2) 방사선치료전 정맥성 신우조형술에서 정상소견을 보였던 예중 21.7%에서 renogram상 일측 또는 양측에 배설지연형을 보였고 반대로 정상 renogram을 나타냈던 예중 비정상 정맥성 신우조형상을 보인 예는 없었다. 3) 방사선치료전 비정상 renogram을 보인 예중 임상진행병기가 심할수록 제삼상(excretory phase)의 변화도 심하였다. 4) Stage Ⅰ또는 Ⅱ인 환자에서 비정상 renogram 소견을 보인 예가 31예중 12예(39.4%)가 있었다. 5) 방사선 치료전에 전 자궁적출술(TAH)를 행한 예에서는 모두 정맥성 신우조형상과 renogram상에 비정상 소견을 보였다. 6) 방사선 치료(point A:8000∼9000 rads, point B:5000∼6000 rads, point CO:11000∼12000 rads) 후치 또는 3개월내에 시행한 renogram 곡선의 변화는 별로 없었다. 그러나 6∼9개월에선 42.8%에서 9∼12개월에서는 약 75%에서 배설기능의 항진을 나타내는 배설상수(excretion index)의 변화가 있었다. 7) 자궁경부암 환자에 있어서 방사선치료 전후의 신의 배설기능의 변화는 특히 renogram상에서 Kex와 excretion index의 변화가 중요하다고 생각된다.

It is a great value to find an early detection of involvement of ureteric obstruction in the carcinoma of cervix. Little or uo knowledge of the condition of the kidneys or the lower urinary tract are able to elucidate by the biochemical studies such as blood nitrogen or urine creatinine in carcinoma of cervix. Findings of urography delineates the condition of urinary tract stasis in the renal pelvis and ureters, however, slight stasis maybe difficult to demonstrate. On the other hand isotope nephrography is accepted as a sensitive method to observe renal function especially in regarding to the excretory function of kidney. It was attempted to analysis the findings of urography conjunction with isotope nephrography in 50 cases of unselected patients with invasive carcinoma of cervix through pre and post irradiation follow up studies. Urography was done as a routine procedure and analysed emphasising changes of collecting systems and ureter condition. Isotope nephrography was carried out by means of 15μci 131I Hippuran injected intravenously and the curves were analysed as follows. Parameter were; time of maximum amplitude (Tmax), half time of maximum amplitude (T½), Kac and Kex value calculated from these two parameters in Tobe's method. The excretion index by Aurell defines the ratio between the maximum activity and the activity measured on the slope of the third phase ten minites after it has reached its maximum. Results:1) 28.8% had an abnormal IVP suggestive of ureteric involvement before irradiation therapy and the patient of stage Ⅲ: and Ⅳ were the great part. 2) 21.7% had abnormal findings of per-irradiation renogram whom showed normal IVP. The other group showed nsrmal IVP which group also showed normal renogram prior irradiation. 3) The more severe the ureteric involvement, the change of excretion index was greater. 4) Even in stage Ⅰ and Ⅱ patient, abnormal renogram was revealed in 12 cases(39.4%) among 31 cases. 5) All cases of TAH showed abnormal findings of IVP and renogram. 6) No definite change of renogram was obtained just after the irradiation therapy (point A:8000∼9000 rads, B:5000∼6000 rads, Co:11000∼13000 rads). Each 3 month follow up study was performed and comparing with preirradiation study which showed significant changes of excretion index of renogram were 42.8% in 6∼9 month follow-up and 75% in 9∼12 month, respectively. 7) It seems to be important to observe the parameter Kex and excretion index of renogram to determine early abnormality of kidney excretory function by means of post-irradiation follow-up study.