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目的:在肾肿瘤患者增强CT(computed tomography)图像上,探讨体表面积(body surface area,BSA)标化后的肾体积与肾功能的相关性。方法:34例肾肿瘤患者于术前1周内均行中腹部增强CT扫描及核素肾动态显像检查。基于动脉期图像测量剔除肿瘤后残余双肾体积,包括肾皮质体积(renal cortical volume,RCV)和肾髓质体积(renal medullary volume,RMV)。肾实质体积(renal parenchymal volume,RPV)为RCV与RMV两者之和。以核素肾动态显像测定的肾小球滤过率(glomerular filtration rate,GFR)为参照标准,将RPV、RCV和BSA标化后的RPV(RPVBSA=RPV/BSA)、RCV(RCVBSA=RCV/BSA)与GFR分别行相关性分析。结果:RPV和RCV与GFR呈中度正相关,r值分别为0.474(P=0.005)和0.448(P=0.008);RPVBSA和RCVBSA与GFR呈中高度正相关,r值分别为0.659(P<0.001)和0.627(P<0.001)。结论:基于增强CT动脉期图像测量的RPV和RCV可以反映肾功能,RPVBSA和RCVBSA能更好地对肾肿瘤患者术前肾功能进行评估。
OBJECTIVE: To investigate the correlation between renal volume and body volume normalized body surface area (BSA) on computed tomography (CT) images of renal tumors. Methods: Thirty-four patients with renal tumors underwent mid-abdominal enhanced CT scan and radionuclide renal dynamic imaging within 1 week before operation. The residual renal volume after tumor exclusion was measured based on arterial phase images, including renal cortical volume (RCV) and renal medullary volume (RMV). Renal parenchymal volume (RPV) is the sum of RCV and RMV. RPV, RCV and BSA labeled RPV (RPVBSA = RPV / BSA), RCV (RCVBSA = RCV) were calibrated with glomerular filtration rate (GFR) / BSA) and GFR respectively. Results: There was a moderate positive correlation between RPV and RCV and GFR, with r values of 0.474 (P = 0.005) and 0.448 (P = 0.008) respectively. There was a moderately positive correlation between RPVBSA and RCVBSA and GFR with r values of 0.659 (P < 0.001) and 0.627 (P <0.001). CONCLUSIONS: RPV and RCV based on enhanced CT arterial phase imaging can reflect renal function, and RPVBSA and RCVBSA can better assess preoperative renal function in patients with renal tumors.