Lüdemann L, Nafz B, Elsner F, Grosse-Siestrup C, Meissler M, Persson P, Gutberlet M, Lengsfeld P, Voth M
Department of Radiotherapy, Charité, Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany.
Rofo. 2011 Mar;183(3):267-73. doi: 10.1055/s-0029-1245904. Epub 2010 Dec 20.
The present study investigates the suitability of computed tomography angiography (CTA) depicting the degree of renal artery stenosis for estimating renal blood flow (RBF) in a kidney.
We investigated renal artery stenosis assessment by CTA in eight adult female hybrid pigs with an ultrasound probe implanted at the renal vein for RBF measurement. An inflatable metal-free cuff was placed around the renal artery to control the RBF. The RBF was then reduced in four steps. For each reduced RBF value and baseline RBF, CTA with a reconstructed slice thickness of 0.625 mm was performed in the arterial phase following injection of 80 ml of nonionic intravenous contrast medium. The radius of the stenotic and non-stenotic renal artery segment was measured in the reconstructed images.
A significant linear correlation (p < 0.0001) was found between the relative apparent stenosis (calculated as the ratio of the radii of the actual stenotic segment and a non-stenotic renal artery segment) and RBF. The linear regression yielded a slope of 0.57 and a y-axis of 24.1 %. A significant linear correlation (p < 0.0001) was also found between the relative true stenosis (the ratio of the radii of the actual stenotic segment and a non-stenotic renal artery segment at baseline) and the RBF. The linear regression yielded a slope of 0.67 and a y-axis of 13.8 %.
The results show that the relative stenosis apparent on CTA differs from the true degree of renal artery stenosis. Nevertheless, the degree of renal artery stenosis determined by CTA provides a reliable estimate of the resulting RBF reduction.
本研究探讨计算机断层血管造影(CTA)描绘肾动脉狭窄程度用于估计肾脏肾血流量(RBF)的适用性。
我们通过CTA对8只成年雌性杂交猪的肾动脉狭窄进行评估,这些猪植入了超声探头以测量肾静脉处的RBF。在肾动脉周围放置一个无金属的可充气袖带以控制RBF。然后分四步降低RBF。对于每个降低的RBF值和基线RBF,在注射80 ml非离子型静脉造影剂后的动脉期进行CTA检查,重建层厚为0.625 mm。在重建图像中测量狭窄和非狭窄肾动脉段的半径。
相对表观狭窄(计算为实际狭窄段与非狭窄肾动脉段半径之比)与RBF之间存在显著线性相关性(p < 0.0001)。线性回归得出斜率为0.57,y轴截距为24.1%。相对真实狭窄(实际狭窄段与基线时非狭窄肾动脉段半径之比)与RBF之间也存在显著线性相关性(p < 0.0001)。线性回归得出斜率为0.67,y轴截距为13.8%。
结果表明CTA上显示的相对狭窄与肾动脉狭窄的真实程度不同。然而,CTA确定的肾动脉狭窄程度可为由此导致的RBF降低提供可靠估计。