64排螺旋CT功能成像技术在兔急性肾损伤诊断中的价值

目的：利用64排螺旋 CT 功能成像技术定量分析 N-硝基-L-精氨酸甲酯(L-NAME)致兔高血压急性肾损伤后肾血流动力学变化,探讨该技术在评估早期肾功能损伤中的应用价值。方法将14只雌性新西兰大白兔随机分成正常对照组(n=6)和 L-NAME 组(n=8)。对照组注入氯化钠(NaCl)溶液,L-NAME 组注入同等量 L-NAME 溶液建立兔高血压急性肾损伤模型；并在注射完毕后行64排螺旋 CT 及单光子发射计算机断层成像(SPECT)检查。同时于注药前后取血检测血肌酐(Cr)。比较分析2组兔肾 Cr 、CT 灌注检查所得各参数值并与病理相对照。利用动态增强 CT 肾图测得 GFRCT 与 SPECT 检查所得 GFRSPECT 进行相关性比较。结果对照组与 L-NAME 组兔肾血容量(BV)、血流量(BF)、毛细血管通透性(PS)、对比剂达峰时间(TTP)及峰值差异有统计学意义(P <0.05)。动态增强 CT 肾图所得 GFRCT 与 GFRSPECT 具有高度相关性。L-NAME 组 GFRCT 均值较对照组明显减低(P =0.000)。L-NAME 组在光镜及大体镜下肾损伤明显。结论64排螺旋 CT 功能成像技术可动态观察并定量分析高血压早期肾功能异常,特别是单侧肾血流异常,是一种有效的定量评估肾功能变化的影像学检查方法。

Value of 64-slice spiral CT functional imaging techniques for diagnosis of acute kidney injury in rabbits

Objective To quantitatively assess renal hemodynamic changes in hypertensive acute kidney injury in rabbits induced by L-NAME using 64-slice spiral CT functional imaging techniques,and to explore the application of these techniques in evaluation of early kidney functional changes.Methods Fourteen female New Zealand white rabbits were randomly divided into normal control group (n=6)and L-NAME group (n=8).The control group was injected NaCl solution and the L-NAME group was injected the same amount of L-NAME solution to make hypertensive acute kidney injury model.64-slice spiral CT and SPECT were scanned af-ter injection.Blood samples were collected before and after injecting NaCl and L-NAME solution to detect serum creatinine (Cr).Cr level and CT perfusion parameters of the two groups were analyzed and compared with the pathology results.GFRCT detected by con-trast-enhanced CT and GFRSPECT detected by SPECT were analyzed by the rank correlation test.Results Renal blood volume,blood flow,permeability surface,time to peak,and peak value had statistically significant differences between the control and L-NAME group (P <0.05).GFRCT and GFRSPECT had obvious correlation.GFRCT of L-NAME group was obviously lower than that of the con-trol group.The kidneys of L-NAME group showed obviously injured under both light microscope and microscope.Conclusion 64-slice spiral CT functional imaging techniques can dynamically observe and quantitatively assess early hypertensive kidney dysfunc-tion,especially unilateral renal blood flow abnormalities.It is an effective examination in quantitatively assessing kidney function.