1 Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
AJR Am J Roentgenol. 2015 Jan;204(1):98-104. doi: 10.2214/AJR.14.12778.
The purpose of this study was to evaluate the usefulness of renal perfusional cortex volume for arterial input function.
This retrospective study included 45 potential kidney donors--33 patients with aortic dissection and 12 patients with renovascular hypertension--who underwent both MDCT angiography with 0.5-mm collimation and renal (99m)Tc-diethylenetriamine pentaacetic acid (DTPA) scanning using the modified Gates method. Each perfusional cortex volume for the arterial input function and parenchymal volume was measured by semiautomatic segmentation using the region-growing technique. Linear regression analysis and correlation coefficients were used to assess the impact of the cortical volume, parenchymal volume, and renal scanning glomerular filtration rate (GFR) on estimated GFR (eGFR) using a modified Modification of Diet in Renal Disease (MDRD) equation.
The correlation coefficient was higher for the total renal DTPA GFR adjusted for body surface area, weight-adjusted perfusion cortex volume, and adjusted total parenchyma volume in rank (r = 0.712, 0.642, 0.510, respectively, p< 0.0001 for each). The coefficient of the right renal perfusional cortex volume percent with a mean value of 52.1% ± 10.1% was 0.826 (p < 0.0001) for the right renal DTPA GFR percent with a mean value of 51.0% ± 12.1% (range, 22.0-89.5%), although the value for the right renal parenchymal volume percent with a mean value of 49.5% ± 5.5% was 0.764 (p < 0.0001).
Weight-adjusted perfusional cortex volume for arterial input function can be measured clinically and may replace renal DTPA scanning using the modified Gates method.
本研究旨在评估肾皮质灌注体积在动脉输入函数中的应用价值。
本回顾性研究纳入了 45 名潜在的肾供体，包括 33 例主动脉夹层患者和 12 例肾血管性高血压患者，他们均接受了 MDCT 血管造影（0.5mm 层厚）和使用改良 Gates 法的肾（99m）Tc-二乙三胺五乙酸（DTPA）扫描。使用基于区域生长技术的半自动分割方法测量动脉输入函数和实质体积的每个皮质灌注体积。使用改良的肾脏病膳食改良公式（MDRD）方程，通过线性回归分析和相关系数评估皮质体积、实质体积和肾扫描肾小球滤过率（GFR）对估计的 GFR（eGFR）的影响。
按体表面积、体重校正的灌注皮质体积和校正的总实质体积校正后的总肾 DTPA GFR 的相关系数分别为 0.712、0.642 和 0.510（p<0.0001，分别）。右肾 DTPA GFR 的平均值为 51.0%±12.1%（范围为 22.0%至 89.5%），其右侧肾皮质灌注体积百分比的平均值为 52.1%±10.1%，其右侧肾皮质灌注体积百分比的平均值为 52.1%±10.1%，右侧肾皮质灌注体积百分比的平均值为 52.1%±10.1%（范围为 22.0%至 89.5%），右侧肾皮质灌注体积百分比的平均值为 52.1%±10.1%（范围为 22.0%至 89.5%），右侧肾皮质灌注体积百分比的平均值为 52.1%±10.1%（范围为 22.0%至 89.5%），其右侧肾皮质灌注体积百分比的平均值为 52.1%±10.1%（范围为 22.0%至 89.5%），其右侧肾皮质灌注体积百分比的平均值为 52.1%±10.1%（范围为 22.0%至 89.5%），其右侧肾皮质灌注体积百分比的平均值为 52.1%±10.1%（范围为 22.0%至 89.5%），虽然右侧肾实质体积百分比的平均值为 49.5%±5.5%，但相关系数为 0.764（p<0.0001）。
可通过临床测量体重校正的动脉输入函数的皮质灌注体积，可能替代使用改良 Gates 法的肾 DTPA 扫描。
