64层螺旋CT灌注参数值与灌注图变化对肾积水患者肾功能评价的指导意义  

Guiding Significance of 64 Slice Spiral CT Perfusion Parameters and Changes of Perfusion Images in Evaluation of Renal Function in Patients with Hydronephrosis

作　　者：陈瑛[1] 李伟亮[1] 吴振启[1] 颜伟[1] 陈磐[1] 李慧峰[1] 王庆[2] 

机构地区：[1]复旦大学附属中山医院青浦分院泌尿外科,上海201700 [2]复旦大学附属中山医院青浦分院普外科,上海201700

出　　处：《中国CT和MRI杂志》2016年第6期82-84,F0002,共4页Chinese Journal of CT and MRI

基　　金：上海市青浦区科学技术发展基金项目:青科发2010-35

摘　　要：目的明确64层螺旋CT灌注参数值与灌注图变化在肾积水患者肾功能评价中的应用价值及对临床治疗的指导意义。方法将我院2013年6月-2015年12月收治65例肾积水患者纳入观察组,由同期进行健康体检者中随机抽取65例作为对照组。患者均应用64层螺旋CT扫描仪检查,先行常规CT平扫,采取多层连续动态电影扫描模式对所选层面进行灌注扫描,之后行CT增强扫描。分析肾积水患者CT影像表现、灌注图,对比肾积水患者与正常体检者肾皮质及肾髓质BF、PS、BV、PBV等CT灌注参数。结果肾积水患者CT影像主要表现为患侧后腹膜纤维化致患侧输尿管狭窄、肾盂输尿管扩张及肾功能减退。肾积水患者的肾皮质BF、PS、BV、PBV等参数值分别为(208.4±28.6)ml·100ml^(-1)·min^(-1)、(30.7±6.6)ml·100ml^(-1)·min^(-1)、(27.5±4.3)ml·100ml^(-1)、(46.6±5.0)ml·100ml^(-1),肾髓质BF、PS、BV、PBV等参数值分别为(102.7±18.2)ml·100ml^(-1)·min^(-1)、(51.7±7.2)ml·100ml^(-1)·min^(-1)、(18.5±4.0)ml·100ml^(-1)、(21.2±1.6)ml·100ml^(-1),均低于正常体检者,差异有统计学意义(P<0.05)。结论64层螺旋CT灌注成像技术具有较高空间与时间分辨率,可获得良好解剖图像与清晰三维图像,利用灌注图及灌注参数对患肾功能进行精确定量评价,进而为临床治疗提供指导。Objective To explore the application value of 64 slice spiral CT perfusion parameters and changes perfusion images in the evaluation of renal function in patients with hydronephrosis and its guiding significance in clinical treatment.Methods 65 cases of patients with hydronephrosis who were admitted in our hospital between June 2013 and December 2015 were included in the observation group. 65 cases of healthy people who underwent physical examination during the same period were randomly selected and included in the control group. All patients were examined with 64 slice spiral CT scanner. Firstly, conventional CT plain scan was performed. Multi-slice continuous dynamic cine scanning mode was adopted to scan the selected layer. Then, CT enhanced scan was performed. The CT imaging findings and perfusion images of patients with hydronephrosis were analyzed. BF, PS, BV, PBV and other CT perfusion parameters of renal cortex and medulla were compared between patients with hydronephrosis and normal healthy people. Results The CT images of patients with hydronephrosis mainly manifested as the posterior peritoneal fibrosis induced ureteral stenosis, pyeloureterectasis and renal hypofunction. Renal cortex parameters such as BF, PS, BV and PBV [（208.4±28.6） ml·100ml-1·min-1, （30.7±6.6） ml·100ml-1·min-1, （27.5±4.3） ml·100ml-1·min-1, （46.6±5.0） ml·100ml-1] and renal medullary parameters such as BF, PS, BV and PBV [（102.7±18.2） ml·100ml-1·min-1, （51.7±7.2） ml·100ml-1·min-1, （18.5±4.0） ml·100ml-1, （21.2±1.6） ml·100ml-1] in patients with hydronephrosis were lower than those in normal controls （P〈0.05）.Conclusions 64 slice spiral CT perfusion imaging is with high spatial and temporal resolution which can obtain good anatomic images and clear three-dimensional images. Perfusion images and perfusion parameters can be used for precise and quantitative evaluation of renal function in patients. Its can evaluate the degree of renal function damage, so as to provide guidance for

关 键 词：肾积水 梗阻 螺旋CT 灌注 肾功能 

分 类 号：R692.2[医药卫生—泌尿科学]