肾动态显像前位采集测定肾脏前移患者肾小球滤过率的可行性

目的探讨单侧肾脏前移患者肾动态显像前位采集测定肾小球滤过率(glomerular filtration rate,GFR)的可行性和准确性。方法选择2017年8月至2021年12月于复旦大学附属中山医院核医学科行肾动态显像，并通过Gates法测定GFR的单侧肾脏前移患者22例，同时进行前位和后位图像采集，并使用后位图像处理双肾数据，使用前位图像处理前移单肾数据，计算相应GFR值。健侧肾后位采集测定的GFR值与前移肾前位采集测定的GFR值之和记作GFR_优化；常规后位采集测定的双肾GFR值之和记作GFR_常规。采用慢性肾脏病流行病学协作组(Chronic Kidney Disease Epidemiology Collaboration,CKD-EPI)推荐的基于血清肌酐(serum creatinine,sCr)方程计算的估算GFR(estimated GFR,eGFR)作为参照值，比较GFR_优化、GFR_常规与eGFR的差异，并进行Pearson相关性分析。结果22例患者前移单肾的前位肾脏深度显著小于后...

Feasibility of measuring GFR of patients with renal antedisplacement by anterior image processing in renal dynamic imaging

Objective: To compare the difference of the measured Glomerular Filtration Rate (GFR) of patients with renal antedisplacement between anterior and regular posterior imaging processing in renal dynamic imaging, and explore whether the GFR obtained by anterior processing is more accurate. Methods: Retrospectively analyzed 22 patients with unilateral renal antedisplacement who underwent renal dynamic imaging to determine the GFR by the department of nuclear medicine, Zhongshan Hospital, Fudan University from August 2017 to December 2021, including 10 males and 12 females, with an average age of 57.5 ± 15.7 years. The anterior and posterior imaging processing were applied simultaneously, posterior for both kidneys and anterior for single kidney with antedisplacement. Add up the GFR obtained from the posterior imaging processing of normal single kidney and the GFR obtained from the anterior imaging processing of kidney with antedisplacement and record the sum as GFR Optimized; Add up the GFRs of both kidneys obtained by regular posterior imaging processing and record the sum as GFR Regular. To compare and make correlation analysis of the GFR Optimized and GFR Regular respectively with the calculated results estimate GFR (eGFR) based on Serum Creatinine (Scr) equation recommended by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Results: As to the 22 patients with unilateral renal antedisplacement, the anterior depth (7.97 ± 1.71) cm] of single kidney with antedisplacement was less than the posterior depth (13.45 ± 2.86) cm], and the difference was statistically significant (t = 8.865, P < 0.001); The GFR (41.43 ± 12.84) ml/min/1.73m2] obtained by anterior imaging processing of single kidney with antedisplacement was higher than that obtained by posterior imaging processing (31.05 ± 12.79) ml/min/1.73m2], and the difference was statistically significant (t = 6.152, P < 0.001); Compared with eGFR (85.46 ± 18.80) ml/min/1.73m2], GFR Optimized (87.29 ± 16.30) ml/min/1.73m2] overestimated 1.836 (95%CI: -1.546 ~ 5.219) ml/min/1.73m2 (Bonferroni adjusted P = 0.815), and they were highly correlated (r = 0.915, P < 0.001); Compared with eGFR, GFR Regular (76.91 ± 13.88) ml/min/1.73m2] underestimated 8.543 (95%CI: 2.199 ~ 14.886) ml/min/1.73m2 (Bonferroni adjusted P = 0.032), and they were moderately correlated (r = 0.654, P = 0.001). Conclusions: When the patient''s kidney moves forward significantly and the anterior depth of the kidney is less than the posterior depth, the GFR obtained by the anterior imaging processing in renal dynamic imaging is more accurate than that obtained by regular posterior imaging processing. In such a case, the anterior imaging processing should be adopted.