Department of Graduate, Hebei North University, 11 Diamond South Road, High-tech Zone, Zhangjiakou City, Hebei Province, 075000, People's Republic of China.
Department of Radiology, Qiqihar Chinese Medicine Hospital, 23 Ping An Nan Jie, Tiefeng District, Qigihar City, Heilongjiang Province, 161005, People's Republic of China.
Eur Radiol. 2018 Mar;28(3):1077-1084. doi: 10.1007/s00330-017-5061-z. Epub 2017 Oct 2.
To present a single-kidney CT-GFR measurement and compare it with the renal dynamic imaging Gates-GFR.
Thirty-six patients with hydronephrosis referred for CT urography and 99mTc-DTPA renal dynamic imaging were prospectively included. Informed consent was obtained from all patients. The CT urography protocol included non-contrast, nephrographic, and excretory phase imaging. The total CT-GFR was calculated by dividing the CT number increments of the total urinary system between the nephrographic and excretory phase by the products of iodine concentration in the aorta and the elapsed time, then multiplied by (1- Haematocrit). The total CT-GFR was then split into single-kidney CT-GFR by a left and right kidney proportionality factor. The results were compared with single-kidney Gates-GFR by using paired t-test, correlation analysis, and Bland-Altman plots.
Paired difference between single-kidney CT-GFR (45.02 ± 13.91) and single-kidney Gates-GFR (51.21 ± 14.76) was 6.19 ± 5.63 ml/min, p<0.001, demonstrating 12.1% systematic underestimation with ±11.03 ml/min (±21.5%) measurement deviation. A good correlation was revealed between both measurements (r=0.87, p<0.001).
The proposed single-kidney CT-GFR correlates and agrees well with the reference standard despite a systematic underestimation, therefore it could be a one-stop-shop for evaluating urinary tract morphology and split renal function.
• A new CT method can assess split renal function • Only using images from CT urography and the value of haematocrit • A one-stop-shop CT technique without additional radiation dose.
介绍一种单肾 CT-GFR 测量方法，并将其与肾动态成像 Gates-GFR 进行比较。
前瞻性纳入 36 例因肾积水而行 CT 尿路造影和 99mTc-DTPA 肾动态成像的患者。所有患者均获得知情同意。CT 尿路造影方案包括非对比、肾实质期和排泄期成像。总 CT-GFR 通过将肾实质期和排泄期之间的整个泌尿系统的 CT 数增加除以主动脉碘浓度与时间的乘积，然后乘以（1-红细胞压积）来计算。然后通过左、右肾比例系数将总 CT-GFR 分为单肾 CT-GFR。通过配对 t 检验、相关分析和 Bland-Altman 图比较单肾 CT-GFR 和单肾 Gates-GFR。
单肾 CT-GFR（45.02±13.91）与单肾 Gates-GFR（51.21±14.76）的配对差值为 6.19±5.63ml/min，p<0.001，表明存在 12.1%的系统低估和±11.03ml/min（±21.5%）的测量偏差。两种测量方法相关性良好（r=0.87，p<0.001）。
尽管存在系统低估，但所提出的单肾 CT-GFR 与参考标准具有相关性和良好的一致性，因此它可以成为评估尿路形态和分肾功能的一站式方法。
• 一种新的 CT 方法可以评估分肾功能；• 仅使用 CT 尿路造影的图像和红细胞压积的值；• 一种无需额外辐射剂量的一站式 CT 技术。
