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利用单层动态计算机断层扫描和闪烁扫描法测定猫肾小球滤过率的比较

Comparison of glomerular filtration rate determined by use of single-slice dynamic computed tomography and scintigraphy in cats.

作者信息

Schmidt David M, Scrivani Peter V, Dykes Nathan L, Goldstein Richard M, Erb Hollis N, Reeves Anthony P

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.

出版信息

Am J Vet Res. 2012 Apr;73(4):463-9. doi: 10.2460/ajvr.73.4.463.

Abstract

OBJECTIVE

To compare estimation of glomerular filtration rate determined via conventional methods (ie, scintigraphy and plasma clearance of technetium Tc 99m pentetate) and dynamic single-slice computed tomography (CT).

ANIMALS

8 healthy adult cats.

PROCEDURES

Scintigraphy, plasma clearance testing, and dynamic CT were performed on each cat on the same day; order of examinations was randomized. Separate observers performed GFR calculations for scintigraphy, plasma clearance testing, or dynamic CT. Methods were compared via Bland-Altman plots and considered interchangeable and acceptable when the 95% limits of agreement (mean difference between methods ± 1.96 SD of the differences) were ≤ 0.7 mL/min/kg.

RESULTS

Global GFR differed < 0.7 mL/min/kg in 5 of 8 cats when comparing plasma clearance testing and dynamic CT; the limits of agreement were 1.4 and -1.7 mL/min/kg. The mean ± SD difference was -0.2 ± 0.8 mL/min/kg, and the maximum difference was 1.6 mL/min/kg. The mean ± SD difference (absolute value) for percentage filtration by individual kidneys was 2.4 ± 10.5% when comparing scintigraphy and dynamic CT; the maximum difference was 20%, and the limits of agreement were 18% and 23% (absolute value).

CONCLUSIONS AND CLINICAL RELEVANCE

GFR estimation via dynamic CT exceeded the definition for acceptable clinical use, compared with results for conventional methods, which was likely attributable to sample size and preventable technical complications. Because 5 of 8 cats had comparable values between methods, further investigation of dynamic CT in a larger sample population with a wide range of GFR values should be performed.

摘要

目的

比较通过传统方法(即闪烁扫描法和锝 Tc 99m 喷替酸盐的血浆清除率)和动态单层计算机断层扫描(CT)测定的肾小球滤过率。

动物

8 只健康成年猫。

步骤

在同一天对每只猫进行闪烁扫描、血浆清除率测试和动态 CT;检查顺序随机。由不同的观察者对闪烁扫描、血浆清除率测试或动态 CT 进行肾小球滤过率计算。通过 Bland-Altman 图比较方法,当 95%一致性界限(方法间平均差异±差异标准差的 1.96 倍)≤0.7 mL/(min·kg)时,认为两种方法可互换且可接受。

结果

比较血浆清除率测试和动态 CT 时,8 只猫中有 5 只的总体肾小球滤过率差异<0.7 mL/(min·kg);一致性界限为 1.4 和 -1.7 mL/(min·kg)。平均±标准差差异为 -0.2±0.8 mL/(min·kg),最大差异为 1.6 mL/(min·kg)。比较闪烁扫描和动态 CT 时,单个肾脏滤过百分比的平均±标准差差异(绝对值)为 2.4±10.5%;最大差异为 20%,一致性界限为 18%和 23%(绝对值)。

结论及临床意义

与传统方法的结果相比,通过动态 CT 估算的肾小球滤过率超出了可接受临床应用的定义,这可能归因于样本量和可预防的技术并发症。由于 8 只猫中有 5 只在两种方法之间具有可比的值,因此应在更大的具有广泛肾小球滤过率值的样本群体中对动态 CT 进行进一步研究。

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