肾脏CT扫描在判断分肾功能中的价值

Value of renal CT scan in the evaluation of split renal function

目的探讨肾脏CT扫描在判断分肾功能中的价值。方法选取2009年6月至2011年6月进行肾脏CT检查患者147例，男66例，女81例。年龄17～87岁，平均53岁。其中梗阻性肾积水73例，肾肿瘤74例。排除74个有肿瘤的肾脏，共220个肾脏。于CT检查后10d内进行肾动态显像（SPECT）检查测量GFR，根据GFR将患肾分为3组：肾功能正常组113个（GFR〉34ml／min）、肾功能轻度减退组66个（GFR20-34ml／min）和肾功能重度减退组41个（GFR〈20ml／min）。采用单因素方差及线性回归分析肾脏CT扫描结果与分肾功能之间的关系。结果肾功能正常组、轻度减退组和重度减退组CT检查测量的肾皮质厚度分别为（0．62±0．11）cm、（0．45-t-O．10）cm及（0．26±0．07）cm，组间比较差异有统计学意义（P〈0．05），肾皮质厚度与GFR高度正相关（r=0．806，P〈0．05）。CT增强扫描检查肾功能正常组、轻度减退组和重度减退组的皮质期CT值分别为（162．1±25．3）HU、（121．60±21．O）HU及（63．5±20．0）HU，组间比较差异有统计学意义（P〈0．05），皮质期增强程度与GFR高度正相关（r=0．851，P〈0．05），肾实质期和排泄期增强程度与GFR中度正相关（r±0．467和r=0．451，P〈0．05）。结论CT扫描显示的肾皮质厚度及皮质期增强程度对判断分肾功能有一定的临床价值。

Objective To study the value of renal CT scan in evaluating split renal function. Methods 147 patients undergone CT scan from June 2009 to June 2011 were involved in this study. There were 73 cases of obstructive hydronephrosis and 74 cases of renal tumors. 66 patients were males and 81 were females with a mean age of 53 years （range 17 -87 years）. GFR detected by single-photon emission computed tomography （SPECT） was used as the reference of split renal function. The kidneys were divided into 3 groups according to the GFR： normal renal function （113 cases, GFR~〉34 ml/min） , mildly impaired renal function （66 cases, GFR： 20 -34 ml/min） and severely impaired renal function （41 eases, GFR 〈 20 ml/min）. One-way ANOVA and linear regression analysis were used to analyze the relationship between the results of CT scan and split renal functions. Results There were significant differences in the cortical thickness among the normal renal function, mildly impaired renal function and severely impaired renal func- tion groups. The cortical thicknesses were （0.62-＋0.11） em, （0.45-＋0.10） cm and （0.26 _＋0.07） cm, respectively （P 〈 0. O1 ）. The renal cortical thickness was strongly correlated with GFR （ r = O. 806, P 〈 0.01 ）. There were significant differences in the enhancement during the cortical phase among the 3 groups, which were （162.1 _＋25.3） HU, （121.6 _＋21.0） HU and （63.5 _＋20.0） HU, respectively （P〈O. O1）. The enhancement during the cortical phase was strongly correlated with the GFR （ r = 0. 851, P 〈 0. O1 ）. The enhancement during the parenchymal phase and excretory phase was moderately correlated with the GFR （r = 0. 467 and r = 0. 451 , P 〈 0.01 ）. Conclusions The renal cortical thickness and the enhancement during the cortical phase detected by CT scan might be useful for the clinical evaluation of split renal func- tion.