64-slice Spiral CT Perfusion Imaging In The Assessment Of Kidney Function

PartⅠ:The Research of Perfusion Imaging Parameter, normal Perfusion Performance and The Influencing Factors in 64—Slice Spiral CT Kidney Perfusion ImagingObjective:①To investigate the methods of MSCT perfusion imaging of the kidney;②To measure all the cortex and medulla perfusion parameters of the nomal kidney;③These perfusion parameters were compared to determine whether there were significant diference between right and left,male and femal.And the correlation between age and perfusion parameters was analyzed.Methods:28 healthy volunteers were studied in this group with SIEMENS Sensation 64-slice spiral CT.A conventional kidney CT plain scan was obtained as a routine to locate the renal hili.Dynamic scans were performed at the location of the renal hili with 50ml nonionic contrast administration(300 mgI/ml)at the speed of 6 ml/s.There are three separate scan sequences for each patient with 30 seconds scan duration respectively.The patient was asked to breathe in and out during the 10s interval of each scan sequence.For each scan sequence,the rotation time is 0.5s,and scan interval is 0.5s,2.5s and 4.5s, respectively.Data postprocessing was performed on Siemens workstation using kidney analyzing software in the package of Body Perfusion.To measure all the cortex and medulla perfusion parameters of the nomal kidney.The perfusion parameters were then compared using the paired t-test and two-sample t-test,to determine whether there were significant diference between right and left,male and femal.And the correlation between age and perfusion parameters was analyzed.Result:①To explore the ideal 64-slice spiral CT kidney perfusion parameter combination.②The time-density curves of 28 bilateral normal renal cortex and medulla are symmetric,even coincident.The mean BF,BV,TTP,PS,PBV of renal cortex were 301.56±68.79ml/100ml/min,38.86±5.83 ml/100ml,11.17±1.12s,42.85±10.88ml/100ml/min,67.53±10.25 ml/100ml respectively,and the mean BF,BV,TIP,PM,PBV of renal medulla were 157.78±34.58 ml/100ml/min,28.53±3.90 ml/100ml,12.38±1.15s,75.59±22.68 ml/100ml/min,28.24±0.94 ml/100ml.③Using analysis of variance,there were no gender and right or left differences in the perfusion parameters(The P value of the BF,BV,TTP,PS,PBV of renal cortex were 0.55,0.73,0.60,0.16,0.68; The Pvalue of the BF,BV,TIP,PS,PBV were 0.09,0.72,0.60,0.09,0.65.P＞0.05),but the perfusion parameters of cortex and medulla was lower in the elder(P＜0.05).Conclusion:①It can measure the cortex and medulla perfusion parameters of the nomal kidney with 64—slice spiral CT perfusion imaging.It can quantitatively evaluate the haemodynamics change in the normal renal tissue..②There were no gender and right or left differences in all the perfusion parameters of the normal kidney,but there were relationship between age with all the perfusion parameters. PartⅡ:64—Slice Spiral CT Perfusion Imaging in the Single Renal Functional Assessment of Hydronephrotic kidneyObjective:The purpose of this study was to evaluate the diagnostic value of MSCT perfusion imaging in assessment of single renal function of hydronephrotic kidney,and to compare the results with GFR which were obtained with SPECTMethods:64-slice spiral CT perfusion were performed in 36 obstructive nephrohydrosis patients whose split renal glomerular filtration rate(GFR)were measured by SPECT renal dynamic imaging.①To compared the perfusion parameters of the renal cortex and renal medulla of the Hydronephrotic kidney with the normal kidney studied in the primary part.②The 72 kidneys were divided into normal renal function,mild and severe renal impairment groups according to renal function.Differences between the groups respect to all the mean perfusion parameters of the renal cortex and renal medulla were assesses by ANOVA.③Using Pearsons correlation test,the correlation between all the mean perfusion parameters of the renal cortex and renal medulla and renal GFR were examined.Result:①The time-density curves of bilateral normal renal cortex and medulla are not symmetric.The mean BF,BV,PS,PBV of renal cortex were 203.20±44.93ml/100ml/min,27.61±3.90 ml/100ml,30.68±6.48 ml/100ml/min,46.49±10.85 ml/100ml;and the mean BF,BV,PM,PBV of renal medulla were 99.89±24.08 ml/100ml/min,18.32±4.32 ml/100ml,51.80±12.09 ml/100ml/min,21.31±2.95ml/100ml.The mean Perfusion parameters of the cortex and medulla of obstructed kidney were lower compared to that of normal kidney.②There were significant differences of all the perfusion parameters of the renal cortex and medulla between three groups(P＜0.05).③The perfusion parameters of the renal cortex and medulla had positive linear corelation with GFR.The best correlatin was the blood flow of the cortex of kidney.The correlation coefficient r=0.852.Conclusion:①It can quantitatively evaluate the haemodynamics condition and functional lesion of the kidney using 64—slice spiral CT perfusion imaging;②It can classify the impaired kidney function;③The perfusion parameters of the renal cortex and medulla had positive linear corelation with GFR.So it is of certain value in evaluating the half renal function of hydronephrosis.