CT增强扫描对肾功能损伤诊断价值的研究

The Value of CT Enhanced Scan in the Diagnosis of Renal Dysfunction

目的探讨和研究CT增强扫描在肾功能损伤中的诊断价值。方法搜集在本院行CT增强扫描诊断肾功能损伤的41例患者,根据慢性肾脏病(CKD)分级标准分为肾功能轻度、中度、重度损伤三组。同时搜集在本院行CT增强扫描和肾小球滤过率估计值(eGFR)均正常的41例患者作为对照组。分析82例患者双肾皮质厚度、双肾实质厚度、CT增强扫描各期CT值对肾功能损伤诊断的可行性和相关性研究,并分析得出最佳诊断指标的诊断阈值范围。结果双肾皮质厚度、双肾皮质厚度之和、CT增强扫描各期双肾强化CT值、CT增强扫描各期双肾强化CT值之和之间的差异均具有统计学意义,双肾皮质厚度之差、双肾实质厚度、双肾实质厚度之和、双肾实质厚度之差、CT增强扫描各期双肾强化CT值之差之间的差异均无统计学意义;双肾皮质之和、CT增强扫描各期双肾强化CT值之和与eGFR呈正相关,其中双肾皮质期CT值之和的相关性最高;正常组与轻度损伤组、中度损伤组与重度损伤组之间的差异有统计学意义,轻度损伤组与中度损伤组的差异无统计学意义,肾功能正常组CT值范围为≥366 HU,肾功能轻中度损伤组的CT值范围为208~366 HU,肾功能重度损伤组CT值范围为<208 HU。结论CT增强扫描各项测量指标对于肾功能损伤的诊断是可行的,其中双肾皮质期CT值之和与eGFR的相关性最高,对肾功能损伤的诊断价值最高,并确定了强化后CT值的阈值范围,这对肾功能损伤的早期诊断及肾功能损伤的初步分级都有一定的指导意义,因此CT增强扫描可作为肾功能评价的重要补充方法。

Objective To investigate and discuss the diagnostic value of CT enhanced scan in renal dysfunction.Methods 41 patients with renal dysfunction diagnosed by CT enhanced scan in our hospital were collected and divided into three groups,namely,mild,moderate and severe,according to the grading standard of chronic kidney disease CKD.In addition,41 patients with normal CT enhanced scan and glomerular filtration rate(eGFR)in our hospital were collected as the control group.The feasibility and correlation study on the diagnosis of renal dysfunction by bilateral renal cortical thickness,bilateral renal parenchymal thickness and CT value at each stage of enhanced CT scan in 82 patients were analyzed,and the diagnostic threshold range of the best diagnostic index was obtained by analysis.Results Bilateral renal cortical thickness,the sum of bilateral renal cortical thickness,CT enhancement scanning periods double kidney strengthening,the differences of the sum of CT enhancement scanning periods double kidney strengthening value were statistically significant,the difference between the double renal cortical thickness,double thickness of renal parenchyma,double thickness of renal parenchyma,double the difference between the thickness of renal parenchyma,the difference of the sum of CT enhancement scanning periods double kidney strengthening value had no statistical significance;The sum of renal cortex and the enhanced CT values of the two kidneys are positively correlated with e GFR,especially,the CT value of the cortical sum of the two kidneys is the most correlated.The results show that,between,the difference is statistically significant between moderate and severe damage group,the mild damage group and normal group.However,there is no statistically significant difference between mild damage group and moderate one.The CT value range of normal renal function group is≥366 HU,and the CT value of mild-to-moderate renal function injury group is in the range of 208-366 HU,and the CT enhanced rangeof severe damage to kidney function group id<208 HU.Conclusion CT enhancement scanning measurement index for diagnosis of renal dysfunction is feasible,among which the correlation between the sum of CT values of bilateral renal cortex and e GFR is the highest,the highest value to the diagnosis of renal damage,and to determine the threshold value of enhanced CT value range,which would be instructive to the early diagnosis of renal damage and preliminary classification,so CT enhanced scan can be used as an important supplement of the renal function evaluation method.