动脉自旋标记MRI评价肾癌部分切除术后残余肾功能的价值

Aterial Spin Labeling Evaluation of Residual Renal Function After Partial Nephrectomy on Renal Cell Carcinoma

目的探讨动脉自旋标记(ASL)评估肾癌患者腹腔镜肾部分切除术后残余肾功能的价值。资料与方法前瞻性地研究15例行腹腔镜肾部分切除术的肾癌患者,于术前1周内及术后3个月行ASL扫描,分析ASL测得健侧肾皮质的肾血流量(RBF)值与放射性核素法测得肾小球滤过率的相关性,比较术前及术后3个月患侧、健侧肾组织RBF值的差异。结果健侧肾皮质RBF值与肾小球滤过率呈正相关(r=0.638,P<0.05)。患侧残余肾组织RBF值[(291.5±37.3)ml/(100 g·min)]较术前肾组织RBF值[(237.8±46.2)/(100 g·min)]升高约53.7 ml/(100 g·min)(P<0.05);健侧肾组织RBF值[(241.1±50.3)ml/(100 g·min)]较术前肾组织RBF值[(290.4±51.8)ml/(100 g·min)]下降约49.3 ml/(100 g·min)(P<0.05)。结论ASL可以用来评价肾功能,且对评估腹腔镜肾癌部分切除术后残余肾血流灌注功能具有一定的价值。

Purpose To investigate the value of arterial spin labeling（ASL） in evaluating renal function in patients with renal cell carcinoma（RCC） after laparoscopic partial nephrectomy. Materials and Methods Fifteen patients with RCC undergoing laparoscopic partial nephrectomy were studied prospectively. The patients were performed ASL scan one week before and three months after operation. The correlation between renal blood flow（RBF） value measured by ASL and the glomerular filtration rate（GFR） measured by radionuclide method in the renal cortex of healthy side was analyzed. The RBF values in the kidney of affected side or healthy side were measured, the difference of which between before operation and three months after operation was compared. Results The RBF value and GFR data in the renal cortex of healthy side had positive correlation（r=0.638, P〈0.05）. In the affected side of kidney, the RBF value of remaining renal tissue [（291.5±37.3） ml/（100g·min）] compared with that of preoperative renal tissue [（237.8±46.2） ml/（100g·min）] increased about 53.7 ml/（100g · min）（P〈0.05）. In the healthy side of kidney, the RBF value of renal tissue [（241.1±50.3） ml/（100 g · min）] compared with that of preoperative renal tissue [（290.4±51.8） ml/（100 g·min）] decreased about 49.3 ml/（100 g·min）（P〈0.05）. Conclusion ASL can be used to evaluate renal function, and it is valuable to evaluate renal perfusion function after laparoscopic partial nephrectomy of RCC.