使用不同容积法估算分肾功能：MRI 与 CT 之间的个体内及个体间比较。
Estimation of split renal function using different volumetric methods: inter- and intraindividual comparison between MRI and CT.
机构信息
Institute of Diagnostic and Interventional Radiology, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
St. John's Medical Center, 1923 South Utica Ave, Tulsa, OK, 74104, USA.
出版信息
Abdom Radiol (NY). 2019 Apr;44(4):1481-1492. doi: 10.1007/s00261-018-1857-9.
PURPOSE
This study aims to determine whether contrast-enhanced (CE)-magnetic resonance imaging (MRI) is comparable to CE-computed tomography (CT) for estimation of split renal function (SRF). For this purpose, two different kidney volumetry methods, the renal cortex volumetry (RCV) and modified ellipsoid volume (MELV), are compared for both acquisition types (CT vs. MRI) with regard to accuracy and reliability, subsequently referred to as RCV/RCV and MELV/MELV.
METHODS
This retrospective study included 29 patients (18 men and 11 women; mean age 62.8 ± 12.4 years) who underwent CE-MRI and CE-CT of the abdomen within a period of 3 months. Two independent readers (R1/R2) performed RCV and MELV in all datasets with corresponding semiautomated software tools. RCV was performed with datasets in the arterial phase and MELV in the venous phase. Statistics were calculated using one-way ANOVA, two-tailed Student's t test, Pearson´s correlation, and Bland-Altman plots with p ≤ 0.05 being considered statistically significant.
RESULTS
In all datasets, SRF was almost identical for both volumetry methods with a mean difference of < 1%. Bland-Altman analysis comparing RCV in CT and MRI showed very good agreement for R1/R2. Interreader agreement was strong for RCV and good for RCV (r = 0.89; r = 0.69). MELV interreader agreement was only moderate (r = 0.54; r = 0.50) with a high range of values. Intrareader agreement was excellent for all measurements, except MELV which showed a high mean bias and range of values (RCV: r = 0.93, RCV: r = 0.98, MELV: r = 0.89, MELV: r = 0.54).
CONCLUSION
Renal volumetric estimates of SRF are almost as accurate and reliable with CE-MRI as with CE-CT using RCV method. In distinction, the calculation of SRF using MELV was inferior to RCV with respect to accuracy and reliability. Thus, RCV method is recommended to estimate SRF, primarily using CT datasets. However, RCV with MRI datasets for kidney volumetry allows for comparable accuracy and reliability while sparing patients and healthy donors of unnecessary radiation exposure.
目的
本研究旨在确定对比增强（CE）磁共振成像（MRI）是否可与 CE 计算机断层扫描（CT）相媲美，用于评估分肾功能（SRF）。为此，我们比较了两种不同的肾脏容积测量方法，即肾皮质容积（RCV）和改良椭球体体积（MELV），对于两种采集类型（CT 与 MRI），这两种方法在准确性和可靠性方面被分别称为 RCV/RCV 和 MELV/MELV。
方法
本回顾性研究纳入了 29 名患者（18 名男性和 11 名女性；平均年龄 62.8±12.4 岁），他们在 3 个月内接受了腹部 CE-MRI 和 CE-CT 检查。两名独立的读者（R1/R2）使用相应的半自动软件工具，对所有数据集进行 RCV 和 MELV 测量。RCV 在动脉期进行，MELV 在静脉期进行。采用单因素方差分析、双侧 Student t 检验、Pearson 相关和 Bland-Altman 图进行统计学分析，p 值≤0.05 被认为具有统计学意义。
结果
在所有数据集，两种容积测量方法的 SRF 几乎相同，平均差异<1%。RCV 在 CT 和 MRI 之间的 Bland-Altman 分析显示，对于 R1/R2，两者具有非常好的一致性。RCV 的读者间一致性很强，而 RCV 的读者间一致性较好（r=0.89；r=0.69）。MELV 的读者间一致性仅为中度（r=0.54；r=0.50），且值范围较大。除 MELV 外，所有测量的内一致性均非常好（RCV：r=0.93，RCV：r=0.98，MELV：r=0.89，MELV：r=0.54），MELV 显示出较高的平均偏差和值范围。
结论
使用 RCV 方法，CE-MRI 对 SRF 的肾容积估计几乎与 CE-CT 一样准确和可靠。相比之下，使用 MELV 计算 SRF 的准确性和可靠性较差。因此，推荐在主要使用 CT 数据集时，使用 RCV 方法来估计 SRF。但是，对于肾脏容积测量，MRI 数据集上的 RCV 可提供相当的准确性和可靠性，同时使患者和健康供体免受不必要的辐射暴露。
Zotero 插件