摘要
目的探讨多层螺旋CT（MSCT）灌注成像在单侧梗阻性积水肾肾功能可复性预测中的价值。方法单侧梗阻性重度肾积水、IVU检查不显影、对侧肾显影正常的患者38例，无糖尿病、痛风、高血压病及泌尿系感染或结核，除外肾占位性病变、肾囊肿、肾炎或慢性肾病且总肾功能正常，行MSCT灌注扫描，梗阻解除后6个月行MSCT灌注扫描和IVU检查，测量积水肾与对侧肾皮质的血流量（BF）、血容量（BV）值。根据术后IVU检查结果分为显影（22例）和不显影（16例）组，统计学比较2组手术前后积水肾的BF和BV值。结果显影组梗阻解除前后MSCT检查积水肾皮质BF分别为（361．6±109．7）和（561．14-165．4）ml／（100g·min），BV值分别为（24．1±10．2）、（35．9±11．3）ml／100g，手术前后差异有统计学意义（t值分别为-3．38、-2．34，P值〈0．01和0．05）。不显影组梗阻解除前后积水肾皮质BF分别为（39．1±22．5）和（38．7±15．4）ml／（100g·min），BV值分别为（8．7±4．4）、（10．3±4．9）ml／100g，手术前后差异无统计学意义（P值均〉0．05）。2组间手术前后BF、BV值的差异均有统计学意义（t值分别为9．09、4．15，P值均〈0．01）。结论MSCT灌注成像在预测IVU不显影的单侧梗阻性积水肾肾功能可复性中具有一定价值。
Objective To evaluate the application of multi-slice CT （MSCT） perfusion scan technique in predicting renal function recovery after unilateral hydronephrosis treatment. Methods Thirty- eight patients with unilateral obstructive hydronephrosis not shown on intravenous urography （IVU） and a normal contralateral kidney were recruited for this study. Patients were divided into detected （D） and unde- tected （UD） groups depending on whether the IVU detected urinary tract obstruction. All patients underwent plain abdominal X-ray, gray-scale ultrasonography, excretory urography and MSCT perfusion scan before and after the treatment. Patients were followed-up at six months or more after the treatment for a mean duration of 12.5 months （ range from 6 to 22）. Results Of the 38 eases, 22 eases were in group D, 16 cases were in group UD. On MSCT, renal cortex blood flow （BF） and blood volume （BV） value after treatment in group D were 561.1± 165.4 ml/（ 100 g · min） and 35.9 ± 11.3 ml/100g compared with before treatment rates of 361.6±109.7 ml/100 g. min） and24.1±10.2 ml/100 g, t= -3.38, -2.34, P〈0.01,0.05. In the UD group, the differences of these parameters were after treatment 38.7 ＋ 15.4 ml/（100 g · min） ,10. 306 ±4. 925 ml/100 g and before treatment 39.1 ± 22.5 ml/（ 100 g·min） and 8.7 ± 4.4 ml/100 g, P 〉 0.05. In the aspects of BF and BV, there were statistically significant differences between group D and group UD both before and after the treatment, t = 9.09, 4.15, P 〈0.01. Conclusions MSCT perfusion can provide a valuable prediction technique of the renal function recovery in patients with unilateral obstructive hydronephrosis. Improvement of renal function can be expected after relief of obstructive hydronephrosis if the patients have a BF 361.6 ml/（ 100 g · min） and BV 24.1 ml/100 g or greater measured by MSCT perfusion.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2012年第3期192-195,共4页
Chinese Journal of Urology
基金
广东省佛山市科技攻关项目（200808108）
