螺旋CT平扫测量肾实质体积评价慢性梗阻侧肾脏肾小球滤过率的价值

目的 探讨螺旋CT平扫测量肾实质体积判断梗阻侧肾脏肾小球滤过率(GFR)的价值.方法 采用螺旋CT平扫扫描双肾,逐层标示各层横断面面积,结合扫描层厚计算肾实质体积,并计算梗阻侧肾实质体积占总的肾实质体积百分比(%Ctvol);另利用99m锝-二乙三胺五醋酸(99mTc-DTPA)肾动态显像技术,应用Gates法测定分肾及总的GFR值,计算梗阻侧肾脏GFR占总GFR的百分比(%GFR).结果 本组25例慢性单侧上尿路梗阻患者,梗阻侧肾脏体积与GFR有明显相关性(r=0.873,P＜0.01),直线回归方程为%GFR=0.008+0.91×%Ctvol.结论 螺旋CT平扫测量肾实质体积可以作为临床上一种实用的评价慢性梗阻侧肾脏GFR的方法.

Value of renal parenchymal volume by noncontrast helical CT in evaluating differential GFR for chronic obstructed kidney

Objective To evaluate the value of renal parenchyma]volume by noncontrast helical CT in evaluating the differential glomerular filtration rate (GFR) for chronic obstructed kidney.Methods Both kidneys of 25 patients with chronic obstructed kidney were scaned by noncontrast helical CT.The renal parenchymal area of each section was marked manually.Renal parenchymal voume was calculated as the sum of renal parenchymal area multiplied by the width of each section.The volume percentage of obstructed kidney(%CTvol) was calculated as well.GFR was determined with 99m Tc-DTPA dynamic imaging system by Gates method.The differential GFR for obstructed kidney (%GFR) was the GFR percentage of obstructed kidney as the total GFR for both kidneys.Results %CTvol was correlated well with %GFR in chronic obstructed kidneys in 25 patients (r=0.873,P＜0.01).The linear correlation equation was % GFR = 0.008±0.91×% Ctvol.Conclusion Renal parenchymal volume by noneontrast helical CT might be used as a clinical method to evaluate the differential GFR for chronic obstructed kidneys.