SPECT／CT直接测量肾脏深度在肾小球滤过率测定中的应用  

Application of renal depth by CT for the measurement of GFR using SPECT/CT

作　　者：杨仪[1] 刘增礼[1] 唐军[1] 洪智慧[1] 尤嘉熙[1] 

机构地区：[1]苏州大学附属第二医院核医学科,215004

出　　处：《中华核医学与分子影像杂志》2012年第4期255-258,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的探讨在以SPECT／CT测定GFR时用CT直接测量肾脏深度代替传统的Tonnesen公式法的必要性和可行性。方法49例患者在接受肾动态显像的同时进行腹部CT平扫，测量两侧肾的深度。将所测值与传统的Tonnesen公式值和SPECT侧位平面图像测量值进行比较，然后将CT和SPECT测得的肾脏深度数据代入到Gates法GFR测量软件中，观察肾脏深度改变对GFR测定值的影响。采用配对t检验对Tonnesen公式法和SPECT测量法测得的肾脏深度值及各自深度值对应的GFR与CT法测得的相关数据间差异进行比较，对Tonnesen公式误差、SPECT测量误差与肾脏深度的关系采用直线相关分析。结果CT测得的肾脏深度分别为右肾（7．04±1．15）cm，左肾（7．18±1．15）cm。与CT测量值相比，Tonnesen公式法低估了肾脏深度[右肾：（5．77±0．90）em，t=-11．50，P〈0．01；左肾：（5．74±0．88）cm，t=12．20，P〈0．01]，而SPECT测量值则高估了肾脏深度[右肾：（7．40±1．15）cm，t=5．19，P〈0．01；左肾：（7．49±1．19）cm，t=5．14，P〈0．01]。Tonnesen公式法误差与肾脏深度呈正相关（右肾：r=0．62，P〈0．01；左肾：r=0．73，P〈0．01），而SPECT测量误差与肾脏深度不相关（右肾r=0．26，P〉0．05；左肾r=0．38，P〈0．01）。Tonnesen公式法得到的两侧肾脏深度差为0．03～0．05cm，而SPECT和CT得到两侧肾脏深度差分别为0．54±0．33（0．01～1．28）cm和0．62±0．45（0．01～1．60）cm。Gates法采用Tonnesen公式肾脏深度低估了GFR，与CT所测肾脏深度对应的GFR相比，误差百分比分别为右肾（-20．92±11．28）％（t=-6．99，P〈0．01），左肾（-23．71±7．71）％（t=-8．73，P〈0．01）；采用SPECT测量则高估了GFR，对应误差百分比为右肾（5．23±9．64）％（t=2．72，P〈0．01），左肾（8．93±9．29）％（t=5．21，P〈0．01）。结论采用SPECT／CT的CT功能精确�Objective To investigate the necessity and feasibility of renal depth measured by CT for the measurement of GFR with SPECT/CT. Methods CT and lateral planar imaging of SPECT along with dynamic 99Tc=-DTPA renal scintigraphy （DRS） was performed in 49 patients. The renal depth esti- mated by Tonnesen formula and SPECT was compared with that measured by CT using paired t-test. GFR was recalculated by the Gates method using the renal depth measured by CT, Tonnesen formula and SPECT. Line- ar correlation analysis was used between the renal depth by CT and measurement error caused by Tonnesen formula and lateral planar imaging of SPECT. Paired t-test was also performed with software SPSS 15.0. Re- suits Compared with CT, the renal depth was substantially underestimated by Tonnesen formula （right kid- ney： （5.77±0.90） cm, t= -11.50, P〈0.01; left kidney： （5.74 ±0.88） cm, t =12.20, P〈0.01）, which resulted in the underestimation of GFR （right kidney ： （ - 20.92 ± 11.28） %, t = - 6.99, P 〈 0.01 ; left kidney： （ -23.71 ± 7.71 ） %, t = - 8.73, P 〈 0.01 ） ; while, it was overestimated by SPECT （ right kidney： （7.40±1.15） cm, t=5.19, P〈0.01; left kidney （7.49±1.19） cm, t=5.14, P〈0.01）, which resulted in the overestimation of GFR （ right kidney ： （5.23± 9.64） %, t = 2.72, P 〈 0.01 ; left kidney ： （8.93 ± 9.29） %, t = 5.21, P 〈 0.01 ）. The error for the calculation of renal depth by Tonnesen formula was positively correlated with the true value （right kidney r = 0.62, P 〈 0.01 ; left kidney r = 0.73, P 〈 0.01 ）. However, there was no correlation between the error of the renal depth measured by SPECT and the true value （right kidney： r = 0.26, P 〉 0.05; left kidney： r = 0.38, P 〈 0.01 ）. Conclusion SPECT/CT can improve the accuracy of GFR measurement by the Gates method using renal depth measured by CT.

关 键 词：肾小球滤过率 体层摄影术 发射型计算机 单光子 体层摄影术 X线计算机 肾脏深度 Tonnesen公式 

分 类 号：R692[医药卫生—泌尿科学]