肾细胞癌患者栓塞前后CT灌注表现及其健侧体积变化  

Perfusion Characteristics of Renal Tumor and Volume of Normal Kidney before and after Arterial Embolization on 64-slice Spiral CT

作　　者：孙昊[1] 薛华丹[1] 刘炜[1] 王沄[1] 赵文敏[1] 金征宇[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院放射科,北京100730

出　　处：《中国医学科学院学报》2009年第2期227-231,I0011,共6页Acta Academiae Medicinae Sinicae

摘　　要：目的应用64层螺旋CT研究肾细胞癌患者肾动脉栓塞前后灌注表现,以及健侧肾脏体积与血肌酐变化情况。方法对21例肾细胞癌患者患侧肾动脉栓塞前6～10d和栓塞后25～28h分别进行64层螺旋CT肾脏灌注扫描,测定栓塞前后肿瘤实质和健侧肾脏皮质的灌注参数,包括血流量、血容量和渗透性。比较栓塞前后肿瘤实质和健侧肾脏皮质的灌注参数变化,以及健侧肾脏体积与患者血肌酐变化。结果21例术后病理均为肾透明细胞癌。栓塞后较栓塞前患侧肾动脉肾细胞癌实质灌注参数显著下降,健侧肾皮质灌注参数显著升高,健侧肾脏体积显著增大(P<0.01),患者血肌酐水平差异无显著性(P>0.05)。结论肾脏灌注参数及体积变化反映了患肾动脉栓塞对健肾代偿功能的影响。多层螺旋CT灌注成像对肾脏病理生理功能的评价具有潜在的临床应用价值。Objective To investigate the perfusion characteristics and compare the volume of normal kidney and serum creatinine （Scr） before and after arterial embolization on 64-slice spiral CT. Methods Totally 21 patients with renal tumor were enrolled. Sixty-four slice spiral CT was used for renal perfusion scan before and after patients underwent tumor arterial embolization. Perfusion characteristics, including blood flow, blood volume, and permeability of renal mass parenchyma and renal cortex in normal kidneys were calculated and the volume of normal kidneys was measured. The values of Scr in all patients were recorded. The perfusion characteristics, the volume of normal kidneys and the level of Scr before and after embolization were compared. Results Renal clear cell carcinoma was pathologically confirmed in all patients. After having supply blood arterial embolization of renal tumor, perfusion characteristics of tumor parenchyma significantly decreased, perfusion characteristics of renal cortex in normal kidney significantly increased, and the volume of normal kidneys was significantly enlarged （P 〈 0.01 ） ; however, the values of Ser in all patients were not significantly different （ P 〉 0.05 ）. Conclusions The perfusion characteristics and volume of kidney may reflect the effects of renal arterial embolization on renal function. Perfusion imaging with multi-slice spiral CT is potentially useful in the evaluation of renal pathophysiologieal characteristics.

关 键 词：肾脏 肾肿瘤 CT 灌注成像 动脉栓塞 

分 类 号：R814.42[医药卫生—影像医学与核医学]