CAJ | 학술논문

目的：应用320排动态容积CT体部灌注成像技术研究肾肿瘤患者正常肾脏皮质灌注特征，分析正常肾皮质灌注参数与肾功能生化检测指标、肾小球滤过率（GFR）的相关性。方法对84例肾脏肿瘤患者术前行320排容积CT灌注成像、检测血肌酐（Scr）和血尿素氮（BUN）值，并于术前行肾动态显像（SPECT）测定单侧 GFR。共得到24个容积序列图形，经后处理得到肾皮质的灌注参数：等效血容量（Equiv BV），表面渗透性（Ps）和血流量（BF）。将BUN和Scr与84例整体肾皮质灌注参数行相关性分析。根据GFR结果将84例患者168侧肾脏分为肾功能正常组和肾功能受损组，比较两组肾皮质灌注参数的差异；将168侧肾脏的灌注参数与单侧肾脏GFR行相关性分析。结果 Scr与84例整体肾皮质Ps呈显著负相关（r=－0.361，P=0.001）。肾功能正常组的肾皮质Ps值明显高于肾功能受损组（P=0.009）；两组间肾皮质的Equiv BV和BF值的比较均无统计学差异（P＞0.05）。Ps与GFR呈显著正相关（r=0.312，P＜0.001）。结论320排动态容积CT灌注成像能定量评价活体肾组织血流动力学状况，可作为评价肾脏功能的补充方法之一，对肾肿瘤的临床治疗及预后评估具有一定的价值。
목적：응용320배동태용적CT체부관주성상기술연구신종류환자정상신장피질관주특정，분석정상신피질관주삼수여신공능생화검측지표、신소구려과솔（GFR）적상관성。방법대84례신장종류환자술전행320배용적CT관주성상、검측혈기항（Scr）화혈뇨소담（BUN）치，병우술전행신동태현상（SPECT）측정단측 GFR。공득도24개용적서렬도형，경후처리득도신피질적관주삼수：등효혈용량（Equiv BV），표면삼투성（Ps）화혈류량（BF）。장BUN화Scr여84례정체신피질관주삼수행상관성분석。근거GFR결과장84례환자168측신장분위신공능정상조화신공능수손조，비교량조신피질관주삼수적차이；장168측신장적관주삼수여단측신장GFR행상관성분석。결과 Scr여84례정체신피질Ps정현저부상관（r=－0.361，P=0.001）。신공능정상조적신피질Ps치명현고우신공능수손조（P=0.009）；량조간신피질적Equiv BV화BF치적비교균무통계학차이（P＞0.05）。Ps여GFR정현저정상관（r=0.312，P＜0.001）。결론320배동태용적CT관주성상능정량평개활체신조직혈류동역학상황，가작위평개신장공능적보충방법지일，대신종류적림상치료급예후평고구유일정적개치。
Objective To study the perfusion characteristics of normal cortex of renal tumor patients on 320-slice dynamic volume CT, and analyze the relationship between the CT perfusion parameters and biochemical index of renal function and CT perfusion parameters and GFR in normal renal cortex. Methods Dynamic contrast-enhanced perfusion imaging with 320-slice dynamic volume CT was prospectively performed before surgery in 84 kidney tumor patients whose BUN and Scr were collected during 3 days before CT scans. Meanwhile, the split renal glomerular filtration rate (GFR) was measured by SPECT renal dynamic imaging before operation. Twenty four CT volumes of the kidneys were acquired. Equiv BV (Equivalent Blood Volume), PS (permeability surface), and BF (blood flow) of normal renal cortex were measured and statistically analyzed. The correlation between the value of BUN and Scr and all parameters of CT perfusion were examined. The 168 kidneys were divided into normal renal function and renal impairment groups according to renal function. Differences between the groups respect to all the mean perfusion parameters of the renal cortex were compared. The correlations between all the mean perfusion parameters of the renal cortex and renal GFR were examined. Results The Ps of renal cortex had negative linear correlation with Scr (r=-0.361, P=0.001). The Ps of the normal renal cortex was significantly higher in normal renal function group than in renal impairment group (P=0.009). No significant differences were found in Equiv BV and BF of renal cortex between the two groups (P>0.05). The Ps of renal cortex had positive linear correlation with GFR (r=0.312, P<0.001). Conclusion The 320-slice dynamic volume CT can quantitatively evaluate the physiological functions of normal renal cortex, and can play import role in clinical treatment and prognosis evaluation of kidney tumor.