肾脏肿瘤患者肾脏皮质的CT灌注参数与肾功能生化检测指标、GFR相关性的研究  

CT perfusion imaging of normal renal cortex of patients with renal tumors and correlative study between CT perfusion parameters and biochemical index of renal function and CT perfusion parameters and GFR in normal renal cortex

作　　者：陈超[1] 郭海若[2] 杨建立[1] 李金[1] 许跃奇[1] 张志刚[1] 吴新淮[1] 

机构地区：[1]北京军区总医院放射诊断科,100700 [2]北京军区总医院附属脑科医院影像科,100700

出　　处：《中华临床医师杂志（电子版）》2015年第20期44-48,共5页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的应用320排动态容积CT体部灌注成像技术研究肾肿瘤患者正常肾脏皮质灌注特征,分析正常肾皮质灌注参数与肾功能生化检测指标、肾小球滤过率(GFR)的相关性。方法对84例肾脏肿瘤患者术前行320排容积CT灌注成像、检测血肌酐(Scr)和血尿素氮(BUN)值,并于术前行肾动态显像(SPECT)测定单侧GFR。共得到24个容积序列图形,经后处理得到肾皮质的灌注参数:等效血容量(Equiv BV),表面渗透性(Ps)和血流量(BF)。将BUN和Scr与84例整体肾皮质灌注参数行相关性分析。根据GFR结果将84例患者168侧肾脏分为肾功能正常组和肾功能受损组,比较两组肾皮质灌注参数的差异;将168侧肾脏的灌注参数与单侧肾脏GFR行相关性分析。结果 Scr与84例整体肾皮质Ps呈显著负相关(r=-0.361,P=0.001)。肾功能正常组的肾皮质Ps值明显高于肾功能受损组(P=0.009);两组间肾皮质的Equiv BV和BF值的比较均无统计学差异(P>0.05)。Ps与GFR呈显著正相关(r=0.312,P<0.001)。结论 320排动态容积CT灌注成像能定量评价活体肾组织血流动力学状况,可作为评价肾脏功能的补充方法之一,对肾肿瘤的临床治疗及预后评估具有一定的价值。Objective To study the perfusion characteristics of normal cortex of renal tumor patients on 320-slice dynamic volume CT, and analyze the relationship between the CT perfusion parameters and biochemical index of renal function and CT perfusion parameters and GFR in normal renal cortex. Methods Dynamic contrast-enhanced perfusion imaging with 320-slice dynamic volume CT was prospectively performed before surgery in 84 kidney tumor patients whose BUN and Scr were collected during 3 days before CT scans. Meanwhile, the split renal glomerular filtration rate （GFR） was measured by SPECT renal dynamic imaging before operation. Twenty four CT volumes of the kidneys were acquired. Equiv BV （Equivalent Blood Volume）, PS （permeability surface）, and BF （blood flow） of normal renal cortex were measured and statistically analyzed. The correlation between the Value of BUN and Scr and all parameters of CT perfusion were examined. The 168 kidneys were divided into normal renal function and renal impairment groups according to renal function. Differences between the groups respect to all the mean perfusion parameters of the renal cortex were compared. The correlations between all the mean perfusion parameters of the renal cortex and renal GFR were examined. Results The Ps of renal cortex had negative linear correlation with Scr （r=-0.361, P=0.001）. The Ps of the normal renal cortex was significantly higher in normal renal function group than in renal impairment group （P=-0.009）. No significant differences were found in Equiv BV and BF of renal cortex between the two groups （P〉0.05）. The Ps of renal cortex had positive linear correlation with GFR （r=0.312, P〈0.001）. Conclusion The 320-slice dynamic volume CT can quantitatively evaluate the physiological functions of normal renal cortex, and can play import role in clinical treatment and prognosis evaluation of kidney tumor.

关 键 词：体层摄影术 x线计算机 肾皮质 肌酸酐 肾小球滤过率 灌注成像 

分 类 号：R737.11[医药卫生—肿瘤]