三维影像重建测量积水肾体积参数在评估肾功能中的应用  

Measuring renal hydronephrosis volume parameters with three-dimensional CT volumetry in evaluating renal function

作　　者：郑蒙蒙 彭意吉 朱伟杰 杨昆霖 丁光璞 关豹 张磊[2] 张进生[2] 李学松[1] 周利群[1] ZHENG Meng-meng;PENG Yi-ji;ZHU Wei-jie;YANG Kun-lin;DING Guang-pu;GUAN Bao;ZHANG Lei;ZHANG Jin-sheng;LI Xue-song;ZHOU Li-qun(Department of Urology,Peking University First Hospital,Institute of Urology,Beijing 100034;Department of Urology,Fuxing Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]北京大学第一医院泌尿外科,北京100034 [2]首都医科大学附属复兴医院泌尿外科,北京100038

出　　处：《现代泌尿外科杂志》2020年第2期116-120,共5页Journal of Modern Urology

摘　　要：目的探讨三维影像重建技术测量积水肾体积参数在评估肾功能中的应用价值。方法回顾性分析2018年1月至2019年4月北京大学第一医院收治的46例肾积水患者的病例资料。测定所有患者肾小球滤过率,对泌尿系增强CT进行三维影像重建后测量肾实质体积、肾积水体积、肾总体积及肾积水体积比例,并对上述指标进行统计分析。结果单侧肾积水患者积水肾和健侧肾在肾实质体积、肾积水体积、肾总体积及肾积水体积比例等指标上的差异均存在统计学意义(P<0.05)。积水侧肾实质体积与肾小球滤过率(GFR)呈线性正相关(r=0.438,P<0.01);肾积水体积(r=-0.385,P<0.05)、肾积水体积比例与GFR(r=-0.417,P<0.01)呈线性负相关。不同程度肾功能受损组间肾实质体积、肾积水体积、肾积水体积比例差异均具统计学意义(P<0.01)。相较其他肾体积参数指标,肾实质体积在诊断区分不同程度肾功能分组之间的诊断效能较高,取肾实质体积为105.69、92.32 mL时,诊断区分肾功能正常与肾功能受损组肾脏、肾功能轻度受损与重度受损组肾脏之间的敏感性和特异性较高。结论三维影像重建技术测量积水肾体积参数在评估肾功能中有一定临床价值,其中肾实质体积在区分不同程度肾功能分组之间的诊断效能较好,值得临床推广应用。Objective To explore the value of three-dimensional(3D)image reconstruction in measuring the volume parameters of hydronephrosis to evaluate renal function.Methods The information of 46 patients with hydronephrosis admitted during Jan.2018 and Apr.2019 were retrospectively analyzed.The glomerular filtration rate(GFR),renal parenchymal volume,hydronephrosis volume,total renal volume and volume ratio of hydronephrosis were measured after 3D reconstruction of urinary enhanced CT.Statistical analysis of the above indicators was performed.Results There were statistical differences in renal parenchymal volume,hydronephrosis volume,total renal volume and hydronephrosis volume ratio between hydronephrosis side and healthy side(P<0.01).There was linear positive correlation between GFR and renal parenchyma volume(r=0.438,P<0.01),and linear negative correlation between renal hydronephrosis volume(r=-0.385,P<0.05),renal hydronephrosis volume ratio and GFR(r=-0.417,P<0.01).There were significant differences in renal parenchymal volume,hydronephrosis volume and hydronephrosis volume ratio among groups with different degrees of renal function(P<0.01).Compared with other parameters of renal volume,the diagnosis efficiency of renal parenchyma volume for distinguishing different renal groups was the most effective.The cut-off value with a good sensitivity and specificity was 105.69 and 92.32 mL.Conclusion The measurement of hydronephrosis volume parameters by 3D image reconstruction is useful in evaluating renal function.Renal paren chymal volume has the highest diagnostic efficiency among different renal function groups,which is worthy of clinical application.

关 键 词：三维重建 影像学体积 肾积水 肾实质体积 分肾功能 

分 类 号：R692.2[医药卫生—泌尿科学]