From the Department of Radiology, the 309th Hospital of Chinese People's Liberation Army, 17 Heishanhu Rd, Haidian District, Beijing 100091, P.R. China.
Radiology. 2016 Apr;279(1):254-61. doi: 10.1148/radiol.2015142757. Epub 2015 Nov 4.
To determine the feasibility and accuracy of a protocol for calculating whole-organ renal perfusion (renal blood flow [RBF]) and regional perfusion on the basis of biphasic computed tomography (CT), with concurrent dynamic contrast material-enhanced (DCE) CT perfusion serving as the reference standard.
This prospective study was approved by the institutional review board, and written informed consent was obtained from all patients. Biphasic CT of the kidneys, including precontrast and arterial phase imaging, was integrated with a first-pass dynamic volume CT protocol and performed and analyzed in 23 patients suspected of having renal artery stenosis. The perfusion value derived from biphasic CT was calculated as CT number enhancement divided by the area under the arterial input function and compared with the DCE CT perfusion data by using the paired t test, correlation analysis, and Bland-Altman plots. Correlation analysis was made between the RBF and the extent of renal artery stenosis. All postprocessing was independently performed by two observers and then averaged as the final result.
Mean ± standard deviation biphasic and DCE CT perfusion data for RBF were 425.62 mL/min ± 124.74 and 419.81 mL/min ± 121.13, respectively (P = .53), and for regional perfusion they were 271.15 mL/min per 100 mL ± 82.21 and 266.33 mL/min per 100 mL ± 74.40, respectively (P = .31). Good correlation and agreement were shown between biphasic and DCE CT perfusion for RBF (r = 0.93; ±10% variation from mean perfusion data [P < .001]) and for regional perfusion (r = 0.90; ±13% variation from mean perfusion data [P < .001]). The extent of renal artery stenosis was negatively correlated with RBF with biphasic CT perfusion (r = -0.81, P = .012).
Biphasic CT perfusion is clinically feasible and provides perfusion data comparable to DCE CT perfusion data at both global and regional levels in the kidney. Online supplemental material is available for this article.
确定基于双期 CT（computed tomography，CT）计算整体器官肾灌注（renal blood flow，RBF）和区域灌注的方案的可行性和准确性，同时以动态对比增强 CT 灌注（dynamic contrast-enhanced CT perfusion，DCE CT perfusion）作为参考标准。
本前瞻性研究获得了机构审查委员会的批准，并获得了所有患者的书面知情同意。对 23 例疑似肾动脉狭窄的患者进行了包括平扫和动脉期成像的双期 CT 肾脏检查，该检查与单次通过动态容积 CT 方案相结合，并进行和分析。双期 CT 衍生的灌注值通过 CT 数增强除以动脉输入函数下的面积来计算，并通过配对 t 检验、相关性分析和 Bland-Altman 图与 DCE CT 灌注数据进行比较。分析 RBF 与肾动脉狭窄程度之间的相关性。所有后处理均由两名观察者独立进行，然后平均作为最终结果。
平均±标准偏差的双期和 DCE CT 灌注 RBF 数据分别为 425.62 ± 124.74 mL/min 和 419.81 ± 121.13 mL/min（P =.53），区域灌注数据分别为 271.15 ± 82.21 mL/min/100 mL 和 266.33 ± 74.40 mL/min/100 mL（P =.31）。双期和 DCE CT 灌注的 RBF（r = 0.93；与平均灌注数据相差 10%[P <.001]）和区域灌注（r = 0.90；与平均灌注数据相差 13%[P <.001]）之间显示出良好的相关性和一致性。肾动脉狭窄程度与双期 CT 灌注的 RBF 呈负相关（r = -0.81，P =.012）。
双期 CT 灌注在临床上是可行的，并可在肾的整体和局部水平提供与 DCE CT 灌注数据相媲美的灌注数据。本文提供了在线补充材料。
