CT测量肾脏深度优化Gates法测定亲属活体供肾肾小球滤过率

Renal depth measured by CT optimize the glomerular filtration rate using the Gates method in living donorkidney transplantation

目的探讨CT测量肾脏深度在Gates法测定亲属活体供肾的肾小球滤过率(GFR)中的临床意义。方法CT测量167例亲属活体肾移植供者肾脏深度,其中137例行99,Tc-DTPA肾动态显像,应用Gates法测量GFR。以CT测量肾脏深度为标准,将Gates法常用的TΦnnesen、Taylor及李乾公式与CT测量的肾脏深度进行对比研究;Gates法测量GFR时保持肾脏及本底感兴趣区等不变,分别利用TΦnnesen、Tylor、李乾公式及CT测量的肾脏深度计算GFR,将4种方法进行对比研究。结果CT测量、TΦnnesen、Taylor和李乾公式估算的左侧肾脏深度分别为:(6.82±0.96)cm、(5.67±0.58)cm、(6.43±0.77)cm和(7.03±0.76)cm,右侧肾脏深度分别为:(7.02±1.00)cm、(5.71±0.59)cm、(6.81±0.72)cm和(7.06±0.70)cm。4种方法计算的左侧肾脏GFR分别为:(45.44±9.04)ml/min.(37.54±6.34)ml/min.(43.39±7.59)ml/min和(46.99±8.04)ml/min,右侧肾脏GFR分别为:(46.61土9.06)ml/min、(37.37±6.02)ml/min、(44.62±6.94)ml/min和(46.70±7.30)ml/min。其中Taylor和李乾公式估算的左/右侧肾脏深度及GFR高于TΦnnesen公式(P<0.01);CT测量的左/右肾脏深度及GFR高于Tonnesen公式及Taylor公式(P<0.01);李乾公式估算的左肾脏深度及GFR高于CT测量(P<0.01),右肾的差异没有统计学意义(P>0.05)。结论CT测量肾脏深度提高了Gates法中肾脏深度估算的准确性,进而提高了GFR测量的准确性,可以优化亲属活体供肾GFR值。

Objective To evaluate the significance of kidney depth obtained by computed tomography (CT) in measuring glomerular filtration rate (GFR) by Gates method in living kidney transplant donors. Methods Individual kidney depth was compared among the estimates of Tonnesen, Taylor and Li Qian formulas and CT measurements in 167 living-related kidney transplant donors respectively. While maintaining the active region of interest of kidney and background unchanged in 137 99mTc-DTPA renal dynamic imaging cases, GFR was measured by Gates' method and individual kidney compared among the estimates of Tonnesen. Taylor and Li Qian formulas and CT measurements. Results Left/right kidney depth obtained by CT, Tonnesen, Taylor and Li Qian formula was 6. 82 ± 0. 96/7. 02 ±1.00, 5. 67 ± 0. 58/5. 71 ±0. 59, 6. 43 ± 0. 77/6. 81 ± 0. 72 and 7. 03 ± 0. 76/7. 06 ± 0. 70 cm;GFR 45. 44 ±9. 04/46. 61 ± 9. 06, 37. 54 ± 6. 34/ 37. 37 ± 6. 02, 43. 39 ± 7. 59/44. 62 ± 6. 94 and 46. 99 ±8. 04/46. 70 ± 7. 30 ml/min respectively. Individual kidney depth and GFR calculated by Taylor and Li Qian were higher than those of Tonnesen formula (P< 0. 01). Individual kidney depth and GFR calculated by CT were higher than those of Tonnesen and Taylor formulas (P<0. 01). Left kidney depth and GFR calculated by Li Qian formula were higher than those of CT measurements (P<0. 01). And no significant difference existed in right kidney(P〉0. 05). Conclusions Kidney depth measured by CT improves the accuracy of kidney depth estimated by Gates method and optimizes GFR in living donors for renal transplant.