Daghini Elena, Primak Andrew N, Chade Alejandro R, Krier James D, Zhu Xiang-Yang, Ritman Erik L, McCollough Cynthia H, Lerman Lilach O
Department of Medicine, Division of Nephrology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Radiology. 2007 May;243(2):405-12. doi: 10.1148/radiol.2432060655.
To prospectively evaluate the feasibility of obtaining reliable measurements of renal hemodynamics and function by using 64-section multidetector CT.
This study was approved by the Institutional Animal Care and Use Committee. Eight pigs (two with induced unilateral renal artery stenosis) were studied with both electron-beam CT and 64-section multidetector CT at 1-week intervals in randomized order. Both kidneys were scanned repeatedly, without table movement, for about 3 minutes after intravenous (IV) administration of a bolus of contrast medium and again during vasodilator challenge (acetylcholine). Images were reconstructed on each CT console but were analyzed on the same independent workstation. Attenuation changes in the kidneys were plotted as function of time, and time-attenuation curves (TACs) were subsequently analyzed to determine regional perfusion and volume, glomerular filtration rate (GFR), and renal blood flow (RBF). Statistical analysis utilized Student t test, analysis of variance (ANOVA), linear regression, and Bland-Altman analysis.
TACs obtained with multidetector CT were qualitatively similar to those obtained with electron-beam CT, as were the quantitative values of renal perfusion and function. RBF correlated significantly between the two techniques (RBF(MD) = 0.96 . RBF(EB) mL/min; R = 0.77, P < .01). GFR(MD) was also similar to GFR(EB) (77.6 +/- 8.3 vs 79.8 +/- 8.8 mL/min, p > .05). Bland-Altman plots showed good agreement between the two techniques. Both techniques similarly detected the differences between stenotic and contralateral kidneys.
The clinical multidetector CT scanner provides reliable measurements of single-kidney hemodynamics and function, which are similar to those obtained with previously validated electron-beam CT.
前瞻性评估使用64层多排螺旋CT获取肾脏血流动力学和功能可靠测量值的可行性。
本研究经机构动物护理和使用委员会批准。8头猪(2头诱导单侧肾动脉狭窄),以随机顺序每隔1周分别接受电子束CT和64层多排螺旋CT检查。静脉注射造影剂团注后,在不移动检查床的情况下,对双侧肾脏重复扫描约3分钟,血管扩张剂激发试验(乙酰胆碱)期间再次扫描。在每个CT操作台上重建图像,但在同一独立工作站上进行分析。将肾脏的衰减变化绘制为时间的函数,随后分析时间-衰减曲线(TAC)以确定局部灌注和容积、肾小球滤过率(GFR)和肾血流量(RBF)。统计分析采用Student t检验、方差分析(ANOVA)、线性回归和Bland-Altman分析。
多排螺旋CT获得的TAC在质量上与电子束CT获得的相似,肾脏灌注和功能的定量值也是如此。两种技术之间的RBF显著相关(RBF(MD)=0.96×RBF(EB) mL/min;R=0.77,P<.01)。GFR(MD)也与GFR(EB)相似(77.6±8.3 vs 79.8±8.8 mL/min,p>.05)。Bland-Altman图显示两种技术之间具有良好的一致性。两种技术同样能检测出狭窄肾脏与对侧肾脏之间的差异。
临床多排螺旋CT扫描仪可提供单肾血流动力学和功能的可靠测量值,与先前经验证的电子束CT所获得的测量值相似。