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肾动态显像前位采集测定肾脏前移患者肾小球滤过率的可行性

Feasibility of measuring GFR of patients with renal antedisplacement by anterior image processing in renal dynamic imaging

    摘要
  • 摘要:
    目的 探讨单侧肾脏前移患者肾动态显像前位采集测定肾小球滤过率(glomerular filtration rate, GFR)的可行性和准确性。
    方法 选择2017年8月至2021年12月于复旦大学附属中山医院核医学科行肾动态显像，并通过Gates法测定GFR的单侧肾脏前移患者22例，同时进行前位和后位图像采集，并使用后位图像处理双肾数据，使用前位图像处理前移单肾数据，计算相应GFR值。健侧肾后位采集测定的GFR值与前移肾前位采集测定的GFR值之和记作GFR优化；常规后位采集测定的双肾GFR值之和记作GFR常规。采用慢性肾脏病流行病学协作组(Chronic Kidney Disease Epidemiology Collaboration, CKD-EPI)推荐的基于血清肌酐(serum creatinine, sCr)方程计算的估算GFR(estimated GFR, eGFR)作为参照值，比较GFR优化、GFR常规与eGFR的差异，并进行Pearson相关性分析。
    结果 22例患者前移单肾的前位肾脏深度显著小于后位肾脏深度(7.97±1.71)cm vs(13.45±2.86)cm, P＜0.001；前移单肾前位采集测定的GFR大于后位采集测定的GFR(41.43±12.84)mL·min-1·(1.73 m2)-1 vs (31.05±12.79)mL·min-1·(1.73 m2)-1, P＜0.001。GFR优化较eGFR高估了1.836 mL·min-1·(1.73 m2)-1(95%CI﹣1.546~5.219, P校正＝0.815)，二者高度正相关(r＝0.915, P＜0.001)；GFR常规较eGFR低估了8.543 mL·min-1·(1.73 m2)-1(95%CI 2.199~14.886, P校正0.032)，二者中度正相关(r＝0.654, P＝0.001)。
    结论 对于肾脏发生明显前移且肾脏前位深度小于后位的患者，肾动态显像前位采集测定的GFR值优于常规后位采集测定的结果。

     

    Abstract:
    Objective To explore the feasibility and accuracy of anterior image processing in renal dynamic imaging to determine glomerular filtration rate (GFR) in patients with unilateral renal antedisplacement.
    Methods A total of 22 patients with unilateral renal antedisplacement who underwent renal dynamic imaging to determine GFR by Gates in the Department of Nuclear Medicine, Zhongshan Hospital, Fudan University from August 2017 to December 2021 were selected. The anterior and posterior image processing were applied simultaneously, posterior images for both kidneys and anterior images for single kidney with antedisplacement. The GFR obtained from the posterior image processing of normal single kidney and the GFR obtained from the anterior image processing of kidney with antedisplacement were added as GFR-optimized; the GFR values of both kidneys obtained from regular posterior image processing were recorded as GFR-regular. The estimated GFR (eGFR) was calculated by the equation based on serum creatinine (sCr) recommended by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). The difference among GFR-optimized, GFR-regular and eGFR were compared, and the correlation was evaluated using Pearson analysis.
    Results The anterior depth of single kidney with antedisplacement was significantly less than the posterior depth (7.97±1.71 cm vs 13.45±2.86 cm, P < 0.001); the value of GFR obtained by anterior imaging processing of single kidney with antedisplacement was significantly greater than that obtained by posterior imaging processing (41.43±12.84 mL·min-1·1.73 m2-1 vs 31.05±12.79 mL·min-1·1.73 m2-1, P < 0.001). Compared with eGFR (85.46±18.80 mL·min-1·1.73 m2-1), GFR-optimized overestimated 1.836 mL·min-1·(1.73 m2)-1 (95%CI﹣1.546-5.219, Padjusted=0.815), and there was a high positive correlation between them (r=0.915, P < 0.001). Compared with eGFR, GFR-regular underestimated 8.543 mL·min-1·1.73 m2-1 (95%CI 2.199-14.886, Padjusted=0.032), and there was a moderate correlation between them (r=0.654, P=0.001).
    Conclusions For the patients with obvious kidney antedisplacement and the anterior depth of the kidney is less than the posterior depth, the GFR obtained from the anterior image processing in renal dynamic imaging is more accurate than that obtained from regular posterior image processing.

     

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