活体供肾64层螺旋CT灌注观察

Perfusion assessment of living donor kidney with 64-slice spiral CT

目的采用64层螺旋CT评估活体供肾CT灌注各参数的特点,测评健康成人肾脏CT灌注参数正常值范围;并与肾功能生化检验和核医学肾动态显像检查进行对比,探讨各灌注参数的应用价值。方法对53名活体供肾行灌注扫描,利用AW4.3工作站平台CT Perfusion 3.0灌注软件,测量皮质BV、BF、MTT、PS、TDC等灌注参数,将所得数据与核医学及生化检查结果进行比较。结果53名健康受检者TDC曲线形态大致相似,左、右侧肾TDC曲线基本吻合,左、右侧肾各灌注参数值基本相同;左、右侧肾皮质各灌注参数平均值分别为:BV:(24.55±5.12)ml/100g,(24.77±4.53)ml/100g;BF:(498.21±115.59)ml/(100g·min),(499.47±108.91)ml/(100g·min);MTT:(3.54±1.08)s,(3.53±1.12)s;PS:(59.42±12.00)ml/(100g·min),(59.95±10.80)ml/(100g·min)。健康成人左、右侧肾皮质各灌注参数正常值范围为:BV:14.51～34.59ml/100g,15.89～33.65ml/100g;BF:271.65～724.77ml/(100g·min),286.01～712.93ml/(100g·min);MTT:1.42～5.66s,1.33～5.73s;PS:35.90～82.94ml/(100g·min),38.78～81.12ml/(100g·min)。肾皮质各CT灌注参数与核医学肾小球滤过率无明显相关性,部分生化指标与灌注参数间有相关性。结论多层螺旋CT灌注可对活体供肾血流灌注参数进行定量测量,初步预测成人肾脏CT灌注参数正常值范围。健康成人肾脏CT各灌注参数与肾小球滤过率之间无线性相关。

Objective To observe the features and normal ranges of CT perfusion parameters of the living donor kidney with 64-slice spiral CT, and to compare the findings with renal radionuclide imaging and biochemical tests. Methods All of 53 donors underwent CT perfusion scanning, and the values of perfusion parameters of renal cortex including BV （blood volume）, BF （blood flow）, MTT （mean transit time）, PS （permeability surface） and TDC （time density curve） were measured at AW 4.3 workstation with CT Perfusion 3.0 software. Results TDC of all the donors were similar and perfusion parameters of bilateral kidney were basically the same. The mean value of cortex perfusion parameters of left and right kidney were as follows, i. e. BV： （24. 55 ±5.12） ml/100 g, （24. 77 ± 4. 53） ml/100 g; BF： （498.21±115.59） ml/（100 g· min）, （499.47±108.91）ml/（100 g · min）; MTT：（3.54± 1.08）s, （3.53± 1.12）s; and PS： （59.42 ± 12.00）ml/（100 g · min）, （59.95 ±10.80）ml/（100 g · min）. The normal ranges of cortex perfusion parameters of left and right kidney were： BV： 14.51-34.59 ml/100 g, 15.89-33.65 ml/100 g;BF： 271.65-724.77 ml/（100 g· min）, 286.01- 712.93 ml/ （100 g · min） ;MTT：1. 42-5.66 s,1. 33-5. 73 s;PS：35. 90-82. 94 ml/（100 g · min）,38.78-81.12 ml/（100 g · min）. There was no significant correlation between all perfusion parameters and GFR measured by nuclear method, while some of biochemical parameters were correlated with perfusion parameters. Conclusion 64-slice spiral CT can assess blood perfusion parameters of living donor kidney quantitatively and estimate the normal ranges of CT perfusion parameters of adult renal cortex preliminarily. In healthy adults, there is no significant correlation between all CT perfusion parameters and GFR.