多层螺旋CT（MSCT）灌注成像评价梗阻性积水肾肾功能的临床研究

目的：探讨多层螺旋CT（MSCT）灌注成像评价梗阻性积水肾肾功能的价值.方法：对36例单侧梗阻性重度肾积水、对侧肾显影正常的患者,按IVU结果分为显影组和不显影组,在梗阻解除前行MSCT灌注扫描,测量积水肾与对侧肾皮质的血流量（BF）、血容量（BV）值,并对两组间积水肾的BF和BV值进行比较.结果：36例中,显影组20例,MSCT检查显示积水肾皮质BF、BV值分别为（412.58±217.56）ml·100 g-1·min-1,（28.66±10.96）ml/100 g;不显影组16例,积水肾皮质BF、BV值分别为（185.24±189.30）ml·100g-1·min-1、（15.6±11.8）ml/100g.两组间积水肾肾皮质BF、BV值比较差异均有统计学意义（P＜0.01）,组内积水肾与对侧肾肾皮质BF、BV值差异显著（P＜0.01）,组间对侧肾肾皮质BF、BV值差异无显著性（P〉0.05）.结论：MSCT灌注成像较IVU能更准确地反映肾功能,在评价单侧梗阻性积水肾肾功能中具有一定价值.

A Clinical Study of the Value of Multi-Slice CT Perfusion for Evaluating the Renal Function Of Adult Patients with Unilateral Obstructive Uropathy

Objective：To explore the value of MSCT perfusion for evaluating the renal function of adult patients with unilateral obstructed hydronephrotic kidney. Methods： This study included 36 patients with severe unilateral obstructive hydronephrotie kidney and a normal contralateral kidney. According to whether the urine tract was shown on IVU, patients were divided into detected （D） and undetected（UD） hydronephrosis group. All patients underwent plain abdominal x-ray, gray-scale uhrasonograpby, excretory urography and MSCT perfusion scanning. Results：Among 36 cases, 20 cases were in D group, 16 cases were in UD group. BF and BV value of renal cortex in Dgroup is （412.58±217.56）ml·100 g^-1 . min^-1、（28.66±10.96） ml/100 g];In UD group,the value is （185.24±189.30）ml·100g^-1·min^-1、（15.64±11.8） ml/10 g. BF and BV value of renal cortex between D group and UD group were significantly different（ t=9.09.4. 15, P 〈0. 01）. Conclusions： MSCT perfusion can provide a more accurate information of renal function than IVP and evaluate the renal functions of hydro-nephrotie kidneys in unilateral obstructed hydronephrotie kidneys.