3D-slicer软件测量肾体积参数在评估亲属肾移植供者肾脏功能中的应用研究

Application of 3D-slicer software to measure renal volume parameters in evaluating renal function of renal transplant donors

目的探讨3D-slicer软件测量肾脏体积参数在评估亲属肾移植供者肾脏功能中的应用价值。方法回顾性分析2019年10月—2022年9月于首都医科大学附属北京友谊医院收治的31例亲属肾移植供者的病例资料。所有患者均行泌尿系增强CT扫描并行肾核素动态显像测定肾小球滤过率(GFR),基于3D-slicer软件平台对所有患者泌尿系结构进行三维重构,测量得肾皮质体积、肾实质体积。基于实验室指标公式法(改良简化MDRD方程、C-G方程)、肾体积法(Herts方程、Choi方程)等4种估算肾小球滤过率(eGFR)预测方程,计算出不同eGFR,分析各肾脏体积参数、不同方程eGFR与实测GFR之间的相关性,分析比较不同方程eGFR与实测GFR之间偏差、准确度和一致性。正态分布的计量资料以均数±标准差(x^(-)±s)表示,组间比较采用t检验;非正态分布的计量资料以M(Q_(1),Q_(3))表示,组间比较采用非参数检验。结果不同方程eGFR与实测GFR之间,相关性较差,而偏差较小,具有良好的准确度及一致性。除了Choi方程估算的eGFR与实测GFR具有弱相关性(r=0.382,P=0.034)外,其他方程eGFR与实测GFR均无显著相关性(P>0.05),其中Herts方程eGFR与实测GFR偏差最小(0.30 mL·min^(-1)·1.73 m^(-2)),10%符合率(61.29%)、30%符合率(96.77%)较高,与实测GFR的一致性最佳,一致性限度为-28.75~29.34 mL·min^(-1)·1.73 m^(-2)。结论相较于实验室指标公式法,肾体积法eGFR的预测效能更优,其中Herts方程的效能最佳,3D-slicer软件测量肾脏体积参数在评估亲属肾移植供者肾功能中具有一定临床价值,值得进一步推广应用。

Objective:To explore the application value of 3D-slicer software in measuring renal volume parameters of renal transplant donors in evaluating renal function.Methods:The data of 31 renal donors admitted to Beijing Friendship Hospital,Capital Medical University from October 2019 to September 2022 were retrospectively analyzed.Glomerular filtration rate(GFR)were measured by SPECT radioactive dynamic imaging,and renal cortex volume(RCV),renal parenchymal volume(RPV)were measured after 3D reconstruction of urinary enhanced CT based on 3D slicer software.The estimated GFR(eGFR)predicted by creatinine-based GFR estimation equations(C-G equation,modified and simplified MDRD equation)and volume-based GFR estimation equations(Herts equation,Choi equation).Different eGFR were calculated,and the correlation between kidney volume parameters,eGFR equations and measured GFR was analyzed.The deviation,accuracy and consistency between different equations eGFR and measured GFR were analyzed and compared.The measurement data of normal distribution were expressed as mean±standard deviation(x^(-)±s),and t-test was used for inter-group comparison.Measurement data with non-normal distribution were represented by M(Q_(1),Q_(3)),and non-parametric test was used for comparison between groups.Results:The correlation between different eGFR and measured GFR is poor,and the deviation is small,and with good accuracy and consistency.Except for the weak correlation between the Choi equation eGFR and measured GFR(r=0.382,P=0.034),there was no significant correlation between eGFR by other equations and measured GFR(P>0.05).Among them,the deviation between the Herts equation-eGFR and measured GFR was the smallest(0.30 mL·min^(-1)·1.73 m-2),with a 10%coincidence rate(61.29%)and a 30%coincidence rate(96.77%),and the best consistency with measured GFR,with a consistency limit of-28.75 to 29.34 mL·min^(-1)·1.73 m-2.Conclusion:Compared with the laboratory index formula method,the Herts equation has better prediction efficiency in estimating GFR,The measurement of renal volume parameters by 3D slicer software has a certain clinical value in evaluating the renal function of renal donors,which is worthy of further application.