原发性高血压靶器官损害患者肾计算机断层摄影术灌注成像初步研究

Preliminary Study of Renal Perfusion Imaging by Computed Tomography in Patients of Essential Hypertension With Target Organ Damage

目的:利用计算机断层摄影术(CT)灌注成像技术研究原发性高血压伴靶器官损害患者的肾皮质血流灌注情况及其变化特点。方法:90例资料完整者,其中原发性高血压患者59例,分为高血压伴靶器官损害组(n=30)和高血压不伴靶器官损害组(n=29),31例健康受试者作为对照组。行128层双源CT全肾容积灌注扫描,测量肾皮质血容量(BV)、血流量(BF)、达峰时间(TTP)和平均通过时间(MTT)等灌注参数。结果:97例检查者完成全肾CT容积灌注成像,其中90例(92.8%)成功行灌注后处理分析。与对照组比较,高血压不伴靶器官损害组BF增加,BV、MTT和TTP减小,但差异均无统计学意义(P均>0.05)。高血压伴靶器官损害组BF较对照组显著减小[(214.6±36.1)ml/(min·100 ml)vs(262.1±26.6)ml/(min·100 ml),P<0.01],但两组BV、TTP和MTT差异无统计学意义(P>0.05)。与高血压不伴靶器官损害组比较,高血压伴靶器官损害组BF显著减小[(268.9±33.1)ml/(min·100 ml)vs(214.6±36.1)ml/(min·100 ml),P<0.01],TTP和MTT亦延长,差异均有统计学意义(P<0.05)。结论:全肾CT容积灌注成像可用于评价高血压靶器官损害患者的肾皮质血流灌注变化情况;在所有灌注参数中,BF较其他参数更能敏感地反应高血压靶器官损害患者的肾微循环灌注变化。

Objective： To assess the renal cortical perfusion parameters by the imaging of computed tomography （CT） in patients of essential hypertension （EH） with target organ damage. Methods： A total of 90 subjects with the entire information including 59 EH patients were studied. The EH patients were divided into 2 groups： EH ＋ target organ damage group,n=30 and EH without target organ damage group,n=29. In addition, there was a Control group,n=31 healthy volunteers. All subjects received 128-slice dual-source CT renal perfusion scanning, the quantitative perfusion of renal cortex blood lfow （BF）, blood volume （BV）, time to peak （TTP） and the mean transit time （MTT） were examined and compared among different groups. Results： There were 90/97 （92.8%） participants eligible for perfusion analysis. Compared to Control group, EH without target organ damage group had the similar parameters of BF, BV, MTT and TTP,P〉0.05. While EH ＋ target organ damage group had decreased BF （214.6 ± 36.1） ml/（min·100 ml ） than Control group （262.1 ± 26.6） ml/（min·100 ml ）,P〈0.01, and BV, TTP, MTT were similar to Control group,P〉0.05. Compared to EH without target organ damage group, the EH ＋ target organ damage group presented decreased BF （214.6 ±3 6.1） ml/（min·100 ml ） vs （268.9 ± 33.1） ml/（min·100 ml ）, P〈0.01 and prolonged MTT, TTP,P〈 0.05. Conclusion： CT imaging may evaluate the renal cortical perfusion changes, and especially BF which can relfect the nbsp;renal perfusion more sensitively than other parameters in EH ＋ target organ damage patients.