肾功能不全动物模型的CT灌注成像研究  

CT Perfusion Imaging on Renal Insufficient Animal Models

作　　者：赵丰年 王亮[2] 吴焕焕[3] 孙浩然[3] ZHAO Fengnian;WANG Liang;WU Huanhuan;SUN Haoran(Department of Radiology,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院超声科,天津300052 [2]天津医科大学总医院泌尿外科,天津300052 [3]天津医科大学总医院放射科,天津300052

出　　处：《中国医学影像学杂志》2023年第6期559-564,共6页Chinese Journal of Medical Imaging

摘　　要：目的分析猪单侧肾动脉狭窄(RAS)和输尿管不全梗阻(UPO)模型的CT灌注成像特征,评估灌注参数与肾小球滤过率(GFR)的相关性。材料与方法选用24只中华实验猪并随机分为RAS组、UPO组和正常对照组,每组8只。通过手术建立猪左侧RAS及左侧UPO模型,并行双肾区容积螺旋穿梭CT灌注成像及^(99)T^(cm)-DTPA动态核素显像。描绘全肾皮质获得时间-密度曲线及CT灌注参数[血流量(BF)、血容量(BV)、平均通过时间(MTT)和毛细血管表面通透性(PS)],评价肾皮质灌注参数与^(99)T^(cm)-DTPA动态核素肾图获得的GFR的相关性。结果RAS组及UPO组患侧肾皮质时间-密度曲线开始上升的时间明显延迟且上升段平缓,波峰延迟且明显低于健侧。RAS组BF明显低于健侧,MTT较健侧明显延长(t=3.594、−3.613,P=0.011);与对照组比较,MTT明显延长(P=0.033)。UPO组BF明显低于健侧,MTT较健侧明显延长(t=10.244、−4.808,P均<0.01);与对照组比较,患侧肾BF及BV明显下降,MTT明显延长(P均<0.05)。双侧、患侧肾皮质BF、MTT与GFR呈线性相关(r=0.709、0.889、−0.579、−0.701,P均<0.05),而BV、PS与GFR无相关性(P均>0.05)。结论肾脏CT灌注成像可以定量评估肾脏皮质血流动力学及肾功能的变化,肾皮质灌注参数中BF和MTT与GFR呈线性相关。Purpose To analyze the CT perfusion imaging characteristics of animal models of unilateral renal artery stenosis(RAS)and ureteral partial obstruction(UPO),and to evaluate the correlation between perfusion parameters and glomerular filtration rate(GFR).Materials and Methods A total of 24 Chinese experimental swines were selected and randomly divided into RAS group,UPO group and normal control group,with 8 in each group.The left RAS and UPO models of swine were established surgically.Then multi-slice spiral CT perfusion imaging and^(99)T^(cm)-DTPA dynamic radionuclide imaging were performed.The time-density curve was obtained by depicting the whole renal cortex,and the CT perfusion parameters included blood flow(BF),blood volume(BV),mean transit time(MTT)and capillary permeability surface(PS)were automatic generated.The correlation between perfusion parameters and GFR was evaluated.Results In RAS and UPO group,the rising time and peak of TDC of affected renal cortex were significantly delayed and the rising section was gentle than those in opposite side.BF and MTT in RAS group were significantly differed than those in contralateral healthy kidney(t=3.594,−3.613,P=0.011).Compared with control group,MTT was significantly prolonged(P=0.033).BF and MTT in UPO group were significantly differed than those in contralateral healthy kidney(t=10.244,−4.808;both P<0.01).Compared with control group,BF and BV decreased significantly,MTT prolonged significantly(all P<0.05).BF and MTT of bilateral and affected renal cortex were linearly correlated with GFR(r=0.709,0.889,−0.579,−0.701;all P<0.05),while BV and PS were not correlated with GFR(both P>0.05).Conclusion Renal CT perfusion imaging can quantitatively evaluate the changes of hemodynamics and function in renal cortical,of which BF and MTT are linearly correlated with GFR.

关 键 词：肾灌注 肾动脉狭窄 输尿管不全梗阻 体层摄影术 X线计算机 模型 动物 

分 类 号：R692[医药卫生—泌尿科学] R6932[医药卫生—外科学] R445.3[医药卫生—临床医学]