CT灌注成像对兔急性肾功能衰竭前期诊断的实验研究

Functional evaluation of prior acute renal failure in rabbits by using CT perfusion

目的:探讨CT灌注成像在实验性兔急性肾功能衰竭前期诊断中的应用价值。方法:兔后腿肌注50%甘油等渗盐水10ml/kg,建立急性肾小管坏死性肾功能衰竭(ARF)动物模型,分别在注射前与注射后6h行CT灌注成像,使用GEPerfusion 2软件测量肾皮质的CT灌注参数值,包括血流量(RBF)、血容量(RBV)、平均通过时间(MTT)和表面通透性(PS),进行统计学分析,并与临床常规指标血肌酐、尿素氮比较其灵敏性。结果:注药前后RBF为(867.75±149.89)ml.min-1.100g-1VS(557.05±222.83)ml.min-1.100g-1,RBV为(74.69±12.84)ml.100g-1VS(41.72±18.93)ml.100g-1,MTT为(4.70±1.27)s VS(4.92±1.04)s,PS为(26.24±5.20)ml.100g-1VS(54.73±10.77)ml.min.100g-1。前后对比,肾皮质RBF、RBV降低差异有极显著性意义(P<0.01),PS值显著增高(P=0.01),MTT较注药前略有增高,但差异无显著性意义(P>0.05),而注药前后6h的血肌酐、尿素氮变化差异无显著性意义。结论:CT灌注成像能准确显示出实验性兔ARF前期的血液动力学变化,较常规血肌酐、尿素氮检查灵敏,对ARF前期诊断具有一定的应用价值。

Objective： To estimate the application of CT perfusion imaging in the diagnosis of prior acute renal failure （ARF） of experimental rabbit. Methods： The model of ARF was established in rabbits through the intramuscular injection of 50% glycerin （10ml/kg） into the hind legs, The multisection dynamic CT perfusion examination was performed for right kidney before and 6 hours after the injection. The mean blood flow of region（RBF）, blood volume of region（RBV）, mean transit time（ MTT）, and permeability surfare（PS） were measured in renal cortex using perfusion 2 software package （GE） and statistically analyzed respectively. The sensitivity of CT perfusion imaging to diagnose ARF was compared with blood serum urea nitrogen and serum creatinine. Results：The mean RBF, RBV, MTT, and PS before injected medicine were （867.75 ± 149.89）ml·min^-1·100g^- 1, （74.69 ± 12.84） ml·100g^- 1, （4.70 ± 1.27）s, （26.24 ± 5.20） ml·min^- 1·100g^- 1, respectively. The mean RBF, RBV, MTT, and PS of 6 hours after injected medicine were （557.05 ± 222.83 ） ml· min^- 1 ·100g ^- 1, （41.72 ± 18.93 ） ml· 100g^-1, （4.92 ± 1.04） s, （ 54.73 ± 10.77 ） ml· min^ - 1·100g^ - 1 respectively. The mean RBF, RBV, and PS of kidney cortex between before and after injecting medicine were statistially singificance （ P = 0.002,0.003, and 0.010）. The M3T increases slightly after injected medicine than before, no significant change in MTT was found. Conclusion： CT perfusion can precisely display the hemodynamic change of ARF model of rabbit in the early stage and more sensitive than the blood serum urea nitrogen and serum creatinine. CT perfusion may be useful and promising for early diagnosis of ARF.