Evaluation Of Renal Function With Unilateral Hydronephrosis By SPECT, CT And

Abstract Purpose:To analyze the correlations between SPECT renal dynamic imaging measured GFR with indexes from different techniques, evaluate their values from those imaging methods in different situations, and explore the optimum model in clinical service.Methods:This was a retrospective study. The numbers of cases were different from different parts, because these choices were completely different when patients visited.Method one:Evaluation of preoperative renal function with unilateral hydronephrosis by SPECT and CT.We reviewed of 115 patients diagnosed with single kidney seeper who finished SPECT renal dynamic imaging and CT examination, measured and counted all patients’ GFR, CT and enhanced CT%, analyzed their correlations, and used ROC to evaluate the value of CT in assessing renal function.Method Two:evaluation of values in renal function with unilateral hydronephrosis by SPECT and Ultrasound.41 patients with hydronephrosis were included in this part, who accomplished both ultrasound and renal dynamic imaging examinations.We analyzed the correlations between GFR%, GFR with sinus separation. All cases were divided into three groups according their CDFI performance, and the means between three groups above were compared by t test, and LSD method was used in multiple comparisons.Method three:evaluation of values in renal function with unilateral hydronephrosis by SPECT and IVP. Prevalence rate was analyzed in different kidneys and analyzed the values in unilateral hydronephrosis by SPECT and FVP.Results: ①There were high correlations between CT%, enhanced CT% with GFR%;(r= 0.58, r=0.61, P< 0.01). ROC was performed in moderate, severe and no function groups to evaluate its value in different situations, and AUC were as following:0.794,0.89 and 0.956 respectively. ②There was a significant negative correlation between sinus separation and GFR (r=-0.58, P=0.000<0.05), and the other significant negative correlation between sinus separation and GFR% (R=-0.66,P=0.000<0.05).③There were 39 cases,17.18%, with bilateral hydronephrosis; 74 cases,32.60%, with right hydronephrosis, and 114 cases,50.22%, with right hydronephrosis in 227 cases included.,X2=37.23, P=0.00< 0.05.④There were more cases which were shown renal function by SPECT than cases in IVP, X2=6.14, P<0.05.Conclusion: ①SPECT had shown high accuracy and specificity in evaluating renal function with unilateral hydronephrosis. CT was an convenient and reliable tool, and played a significant role in this field, but it was never accurate in moderate group all the time.②Sinus separation from ultrasound was accurate in evaluation residual renal function and there was high correlation between sinus separation and GFR. But, qualitative classification by Color Doppler flow imaging could not accurately reflect the residual renal function.③It was not suitable to regard IVP as an accurate indication which decided its final diagnosis, although IVP could be used as a powerful tool in clinic work, especially in patients who suffered with chronic hydronephrosis for a long time and their renal function had been severely damaged. ④There was higher rate in left kidney than counterpart’s in unilateral hydronephrosis, and higher rate than double seeper simultaneously.