Clinical Study Of Glomerular Filtration Rate In Living Kidney Donors By Enhanced CT Scanning

PART ONECOMPARISON STUDY OF ENHANCED CT SCANNING ANDSPECT IN MEASUREMENT OF GLOMERULAR FILTRATIONRATE IN LIVING KIDNEY DONORSObjectiveTo investigate a new technique for measuring glomerular filtration rate (GFR) inliving kidney donors by multi-phase enhanced CT scanning and to study the correlation ofGFR measured by it and GFR measured by SPECT.MethodsSixty adult kidney donors were underwent renal multi-phase enhancement CTscan.The CT protocol consisted of an unenhanced scan and three contrast-enhanced scansafter starting an injection of90ml of iohexol(100ml:37g I) using an injection rate of4.0ml/s,and glomerular filtration rate was calculated with Patlak equation.As areference,the exact information of GFR was gained by performing renal SPECT with99mTc-DTPA.GFR measured by the two methods were analyzed by linear regressionanalysis.ResultsIn60renal donors,GFR of the left and right kidney measured by CT is(64.36±5.38)ml/min and (65.72±5.73)ml/min,and the total GFR is (129.48±10.49)ml/min;and GFR measured by SPECT is (41.74±5.49)ml/min,(43.36±6.31) ml/min and(85.09±10.73)ml/min.Linear regression analysis show that the two groups GFR has wellcorrelation.The correlation coefficient of the left kidney GFR and the right kidney GFR is0.877and0.877, P<0.01, with a regression line of GFR(CT)=28.525+0.859×GFR(SPECT), n=60and GFR(CT)=31.209+0.785×GFR(SPECT),n=60;the correlation coefficient ofthe total GFR is0.867, P<0.01，with a regression line of GFR(CT)=57.337+0.848× GFR(SPECT), n=60.ConclusionsGFR measured by enhanced CT scanning has a well correlation with GFR measuredby SPECT.It can complete the preoperative evaluation of kidney function and anatomy ofliving kidney donors simultaneously by using enhanced CT scanning. PART TWOGLOMERULAR FILTRATION RATE IN LIVING KIDNEYDONORS MEARSURED BY ENHANCED CT WITHDIFFERENT SCANNINGObjectiveTo study the differences on measuring glomerular filtration rate in living kidneydonors by enhanced CT with different scanning.MethodsThirty adult kidney donors were underwent renal multi-phase enhancement CTscan.The CT protocol consisted of an unenhanced scan and four contrast-enhancedscans(arterial phase,early venous phase,late venous phase and CTU phase).GFR wascalculated three times in each kidney donor,and the results were assigned3groups,i.e,group A,GFR was calculated with two sets of datas from arterial phase andearly venous phase; group B,GFR was calculated with two sets of datas from arterial phaseand late venous phase; group C,GFR was calculated with three sets of datas from arterialphase、early venous phase and late venous phase. As a reference,the exact information ofGFR was gained by performing renal SPECT with99mTc-DTPA.ResultsThe linear regression analysis showed that GFR of group C had the best correlationwith GFR gained by SPECT,the correlation coefficient of the left kidney GFR、the rightkidney GFR and total GFR is0.906,0.905and0.899;and group B take the second placewith the correlation coefficient is respectively0.890,0.891and0.889;group A had thelowest correlation with the correlation coefficient is respectively0.875,0.875and0.864.ConclusionsUsing late venous phase scanning and gain more data between arterial phase andvenous phase can improve the accuracy of GFR in living kidney donors by enhanced CTscanning.