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采用全自动三维容积 CT 对整个肾脏进行体积评估的肾脏体积的纵向变化:与肾功能和疾病进展的关系。

Longitudinal changes in renal volumes evaluated by automated three-dimensional volumetric computed tomography of the whole kidney: The association with the renal function and disease progression.

机构信息

Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan.

Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan.

出版信息

Eur J Radiol. 2024 Jan;170:111245. doi: 10.1016/j.ejrad.2023.111245. Epub 2023 Nov 29.

DOI:10.1016/j.ejrad.2023.111245
PMID:38042018
Abstract

PURPOSE

To clarify the changes in the total renal volume over time with changes of the renal function using automated 3D volumetric CT of the whole kidney and to evaluate the usefulness of the total renal volume CT measurement in predicting chronic kidney disease (CKD) grade progression.

METHODS

A total of 961 patients who underwent abdominal CT at least twice (an interval of more than 4 years) were included. The automated 3D volumetric CT measurement of the whole kidney was performed at the initial and latest CT examination. Patients with CKD grade G2 at the time of the initial CT were divided into two groups: a progression group (CKD grade progressed to G3-G5) and a non-progression group. Changes in the renal volume over time were compared between the two groups.

RESULTS

The volume of both kidneys measured on initial CT was positively correlated with eGFR (ρ = 0.490, p < 0.001). There was a significant difference in the initial volume of both kidneys among CKD grades (p < 0.001, G1:318.7 ± 60.5 ml, G2:275.5 ± 53.5 ml, G3:233.7 ± 46.9 ml, G4:183.2 ± 22.5 ml, G5:157.7 ± 77.4 ml). When comparing the progression and non-progression groups, the initial volume of both kidneys was significantly smaller in the progression group, compared with the non-progression group (252.0 ± 50.6 ml vs. 278.9 ± 53.7 ml). In addition, the annual reduction volume in both the right and left kidneys was significantly greater in the progression group than in the non-progression group (p < 0.001).

CONCLUSION

The automated 3D volumetric CT measurement of the whole kidney has the potential to monitor changes in renal volume over time with changes of the renal function.

摘要

目的

利用全自动 3D 容积 CT 对整个肾脏进行测量,阐明随着肾功能的变化,肾脏总体积随时间的变化,并评估肾脏总体积 CT 测量在预测慢性肾脏病(CKD)分级进展中的作用。

方法

共纳入 961 例至少两次(间隔>4 年)行腹部 CT 检查的患者。在首次和最近的 CT 检查时进行全自动 3D 容积 CT 测量。首次 CT 时患有 CKD G2 期的患者被分为进展组(CKD 分级进展至 G3-G5 期)和非进展组。比较两组患者的肾脏体积随时间的变化。

结果

首次 CT 时双肾体积与 eGFR 呈正相关(ρ=0.490,p<0.001)。CKD 各分期之间双肾初始体积存在显著差异(p<0.001,G1:318.7±60.5ml,G2:275.5±53.5ml,G3:233.7±46.9ml,G4:183.2±22.5ml,G5:157.7±77.4ml)。比较进展组和非进展组,进展组的双肾初始体积显著小于非进展组(252.0±50.6ml vs. 278.9±53.7ml)。此外,进展组的右肾和左肾的年容积减少量明显大于非进展组(p<0.001)。

结论

全自动 3D 容积 CT 对整个肾脏的测量有可能监测肾功能变化时肾脏体积随时间的变化。

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