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目的探讨螺旋CT平扫测量肾实质体积判断梗阻侧肾脏肾小球滤过率(GFR)的价值。方法采用螺旋CT平扫扫描双肾,逐层标示各层横断面面积,结合扫描层厚计算肾实质体积,并计算梗阻侧肾实质体积占总的肾实质体积百分比(%CTvol);另利用99m锝-二乙三胺五醋酸(99mTc-DTPA)肾动态显像技术,应用Gates法测定分肾及总的GFR值,计算梗阻侧肾脏GFR占总GFR的百分比(%GFR)。结果本组25例慢性单侧上尿路梗阻患者,梗阻侧肾脏体积与GFR有明显相关性(r=0.873,P<0.01),直线回归方程为%GFR=0.008+0.91×%Ctvol。结论螺旋CT平扫测量肾实质体积可以作为临床上一种实用的评价慢性梗阻侧肾脏GFR的方法。
Objective To evaluate the value of spiral CT in measuring the volume of renal parenchyma to determine the glomerular filtration rate (GFR) in obstructive kidney. Methods The renal tubules were scanned plainly by spiral CT. The cross-sectional area of each layer was marked layer by layer. The volume of renal parenchyma was calculated with the scan thickness. The volume of renal parenchyma in obstructive renal tubules (% CTvol) Technetium-Diethylenetriamine pentaacetic acid (99mTc-DTPA) renal dynamic imaging, the Gates method was used to determine the total and partial GFR, and the percentage of total GFR in the obstructive kidney (% GFR) was calculated. Results In 25 patients with chronic unilateral upper urinary tract obstruction, the volume of obstructed kidney was significantly correlated with GFR (r = 0.873, P <0.01). The linear regression equation was% GFR = 0.008 + 0.91 ×% Ctvol. Conclusion Spiral CT plain measurement of renal parenchyma volume can be used as a practical clinical evaluation of chronic obstructive renal GFR.