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利用碘对比剂的肾分积率测定肾小球滤过率(GFR):一种方便快捷的单肾 CT-GFR 技术。

Determination of glomerular filtration rate (GFR) from fractional renal accumulation of iodinated contrast material: a convenient and rapid single-kidney CT-GFR technique.

机构信息

Department of Radiology, the 309th Hospital of Chinese People's Liberation Army, 17 Heishanhu Road, Haidian District, Beijing, 100091, People's Republic of China.

Department of Radiology, Fudan University Shanghai Cancer Center, 270 Dongan Road, Shanghai, 200032, People's Republic of China.

出版信息

Eur Radiol. 2018 Jul;28(7):2763-2771. doi: 10.1007/s00330-017-5289-7. Epub 2018 Feb 9.

Abstract

OBJECTIVES

To develop a convenient and rapid single-kidney CT-GFR technique.

METHODS

One hundred and twelve patients referred for multiphasic renal CT and 99mTc-DTPA renal dynamic imaging Gates-GFR measurement were prospectively included and randomly divided into two groups of 56 patients each: the training group and the validation group. On the basis of the nephrographic phase images, the fractional renal accumulation (FRA) was calculated and correlated with the Gates-GFR in the training group. From this correlation a formula was derived for single-kidney CT-GFR calculation, which was validated by a paired t test and linear regression analysis with the single-kidney Gates-GFR in the validation group.

RESULTS

In the training group, the FRA (x-axis) correlated well (r = 0.95, p < 0.001) with single-kidney Gates-GFR (y-axis), producing a regression equation of y = 1665x + 1.5 for single-kidney CT-GFR calculation. In the validation group, the difference between the methods of single-kidney GFR measurements was 0.38 ± 5.57 mL/min (p = 0.471); the regression line is identical to the diagonal (intercept = 0 and slope = 1) (p = 0.727 and p = 0.473, respectively), with a standard deviation of residuals of 5.56 mL/min.

CONCLUSION

A convenient and rapid single-kidney CT-GFR technique was presented and validated in this investigation.

KEY POINTS

• The new CT-GFR method takes about 2.5 min of patient time. • The CT-GFR method demonstrated identical results to the Gates-GFR method. • The CT-GFR method is based on the fractional renal accumulation of iodinated CM. • The CT-GFR method is achieved without additional radiation dose to the patient.

摘要

目的

开发一种方便快捷的单肾 CT-GFR 技术。

方法

前瞻性纳入 112 例接受多期肾 CT 和 99mTc-DTPA 肾动态成像门控 GFR 测量的患者,并随机分为两组,每组 56 例:训练组和验证组。在肾实质期图像的基础上,计算肾部分摄取分数(FRA),并与训练组的门控 GFR 相关。从这种相关性中得出了一个用于单肾 CT-GFR 计算的公式,并用验证组的单肾门控 GFR 通过配对 t 检验和线性回归分析进行验证。

结果

在训练组中,FRA(x 轴)与单肾门控 GFR(y 轴)相关性良好(r = 0.95,p < 0.001),产生了一个用于单肾 CT-GFR 计算的回归方程 y = 1665x + 1.5。在验证组中,两种单肾 GFR 测量方法的差异为 0.38 ± 5.57 mL/min(p = 0.471);回归线与对角线(截距 = 0,斜率 = 1)相同(p = 0.727 和 p = 0.473,分别),残差标准差为 5.56 mL/min。

结论

本研究提出并验证了一种方便快捷的单肾 CT-GFR 技术。

要点

  • 新的 CT-GFR 方法大约需要 2.5 分钟的患者时间。

  • CT-GFR 方法与 Gates-GFR 方法的结果相同。

  • CT-GFR 方法基于碘化物 CM 的肾部分摄取分数。

  • CT-GFR 方法在不增加患者额外辐射剂量的情况下实现。

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