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计算机断层扫描校正肾感兴趣区在单肾肾小球滤过率评估中对中重度肾积水患者的应用价值

The Application Value of the Renal Region of Interest Corrected by Computed Tomography in Single-Kidney Glomerular Filtration Rate for the Evaluation of Patients With Moderate or Severe Hydronephrosis.

作者信息

Yin Haixia, Liang Wenli, Zhao Deshan

机构信息

Department of Nuclear Medicine, The Second Hospital of Shanxi Medical University, Taiyuan, China.

出版信息

Front Physiol. 2022 May 9;13:861895. doi: 10.3389/fphys.2022.861895. eCollection 2022.

Abstract

This study aimed to investigate the application value of the renal region of interest (ROI) corrected by computed tomography (CT) in single-kidney glomerular filtration rate (GFR) in patients with hydronephrosis. A total of 46 patients with hydronephrosis were divided into four groups based on their degree of unilateral hydronephrosis: a normal group (left kidney and right kidney) and three abnormal groups (mild, moderate, and severe hydronephrosis). GFR was measured using the two-sample method (tGFR). The single-kidney GFR of each patient was derived from differential renal function values in dynamic renal imaging multiplied by GFR. The single-kidney GFRs, including GFR from the Gates method (gGFR) and CT area-corrected GFR (aGFR), were compared with tGFR. A paired-sample -test and Pearson's test were used for data analysis. < 0.05 was considered statistically significant. There were no significant differences between aGFR and tGFR in patients in the normal, mild hydronephrosis, and moderate hydronephrosis groups ( = -0.604∼1.982, all > 0.05), but there was a significant difference between them in the severe hydronephrosis group ( = 2.302, < 0.05). There were no significant differences between gGFR and tGFR in the normal and mild hydronephrosis groups ( = 0.194∼0.962, all > 0.05), but there was a significant difference between them in the moderate and severe hydronephrosis groups ( = 3.321, 3.494, < 0.05). Both gGFR and aGFR were correlated with tGFR, with aGFR being more strongly correlated ( = 0.890, < 0.001). In patients with moderate hydronephrosis, aGFR is more strongly correlated with tGFR than gGFR. However, in patients with severe hydronephrosis and accompanying renal morphological changes, the aGFR measured by the renal ROI area-correction method using CT has higher accuracy and better clinical application value than the conventional gGFR.

摘要

本研究旨在探讨计算机断层扫描(CT)校正的肾感兴趣区(ROI)在肾盂积水患者单肾肾小球滤过率(GFR)中的应用价值。将46例肾盂积水患者根据单侧肾盂积水程度分为四组:正常组(左肾和右肾)和三个异常组(轻度、中度和重度肾盂积水)。采用双样本法(tGFR)测量GFR。每位患者的单肾GFR由动态肾显像中的分肾功能值乘以GFR得出。将包括Gates法GFR(gGFR)和CT面积校正GFR(aGFR)在内的单肾GFR与tGFR进行比较。采用配对样本t检验和Pearson检验进行数据分析。P<0.05被认为具有统计学意义。正常组、轻度肾盂积水组和中度肾盂积水组患者的aGFR与tGFR之间无显著差异(P=-0.604~1.982,均P>0.05),但在重度肾盂积水组中两者存在显著差异(P=2.302,P<0.05)。正常组和轻度肾盂积水组的gGFR与tGFR之间无显著差异(P=0.194~0.962,均P>0.05),但在中度和重度肾盂积水组中两者存在显著差异(P=3.321、3.494,P<0.05)。gGFR和aGFR均与tGFR相关,aGFR的相关性更强(r=0.890,P<0.001)。在中度肾盂积水患者中,aGFR与tGFR的相关性比gGFR更强。然而,在重度肾盂积水并伴有肾脏形态改变的患者中,采用CT肾ROI面积校正法测量的aGFR比传统的gGFR具有更高的准确性和更好的临床应用价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/120a/9124959/e7a187ab73e7/fphys-13-861895-g001.jpg

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