MSCT灌注成像评价兔积水肾功能

Renal functional assessment of hydronephrotic kidney of rabbit with MSCT perfusion imaging

目的探讨MSCT灌注成像评估单侧输尿管不全梗阻致积水肾肾功能的价值。方法成年雄性新西兰大白兔30只,随机选取6只作为对照组,其余24只通过左侧输尿管不全梗阻制作积水肾模型,平均分为4组,分别于梗阻后1、3、5和7周行MSCT灌注扫描和SPECT检查。每组检查后处死1只用于病理观察。结果①随梗阻时间延长,积水肾皮质、髓质的BF、BV值持续下降,与对照组比较差异均有统计学意义(P<0.05)。对照组肾皮、髓质的MTT、P值与梗阻1周、3周时差异均无统计学意义(P>0.05),与梗阻5周、7周比较差异有统计学意义(P<0.05)。随梗阻时间延长,MTT值延长、P值下降。②梗阻后,肾盂和肾小管扩张越来越明显,间质纤维化逐渐加重。结论MSCT灌注成像为评价肾脏功能提供了新的检测手段。积水肾皮质、髓质BF、BV持续下降,MTT和PS值的变化可能与积水肾纤维化程度有关。

Objective To approach the value of MSCT perfusion imaging in assessment of renal function of unilateral hydronephrotic kidney induced by partial ureteral obstruction.Methods Thirty healthy adult male rabbits were involved in the study.Six were selected randomly as controls,the other 24 were divided into 4 groups of hydronephrotic kidney（each n=6）.All animals underwent MSCT perfusion scanning and SPECT examination at 1,3,5 and 7 weeks after obstruction.After examination,hydronephrotic kidneys were microscopically examined.Results ①After obstruction,BF and BV of renal cortex and medulla gradually decreased,and there were difference between control group and the other 4 groups（P〈0.05）.Changes of BF and BV value was coincident with the results of SPECT examination.No difference of MTT and P value of renal cortex and medulla was found among control group,1 and 3 week group,but between 5 and 7 week group.②Histologically,renal pelvis and renal tubules dilated with some atrophic renal tubules.Intertubular distance widened because of interstitial fibrosis.The changes mentioned above became more serious as time went on.Conclusion MSCT perfusion imaging provides a novel approach for functional examination of hydronephrotic kidney.BF and BV value in obstructive renal cortex and medulla decrease continuously,and changes of MTT and P value are probably relative to the fibrotic degree of hydronephrotic kidney.