Relationship between CT renal imaging parameters and glomerular filtration rate measured by 99mTc-DTPA renal dynamic imaging
10.3760/cma.j.cn115396-20241201-00368
- VernacularTitle:CT肾脏影像学参数与 99mTc-DTPA肾动态显像法测定肾小球滤过率之间的关系
- Author:
Mengmeng ZHENG
1
;
Yichen ZHU
;
Ye TIAN
Author Information
1. 首都医科大学附属北京友谊医院泌尿外科 北京市卫生健康委员会泌尿外科研究所，北京 100050
- Keywords:
Kidney neoplasms;
Hydronephrosis;
Kidney failure;
Image reconstruction
- From:
International Journal of Surgery
2025;52(3):181-188
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the relationship between CT renal imaging parameters measured by 3D-slicer software and glomerular filtration rate (GFR) measured by 99mTc-DTPA renal dynamic imaging. Methods:A retrospective analysis was conducted on the clinical data of 177 patients (65 renal transplant donors, 60 patients with obstructive nephropathy, and 52 patients with renal tumors) admitted to Beijing Friendship Hospital, Capital Medical University from January 2015 to August 2021. GFR was measured for all patients. After three-dimensional imaging reconstruction of the urinary system enhanced CT using the 3D-slicer software platform, renal cortical volume, parenchymal volume, and average CT values were measured. A total of 189 kidneys (65 healthy kidneys, 72 hydronephrotic kidneys, and 52 tumor kidneys) were analyzed for the above parameters. The statistical analysis methods used independent sample t-test, one-way analysis of variance (ANOVA), Pearson correlation analysis, and receiver operating characteristics (ROC) curve analysis. Results:Compared with healthy kidneys, renal cortex volume and parenchyma volume in hydronephrotic and tumor kidneys were significantly reduced ( P<0.001), and GFR was significantly lower ( P<0.001). Among the 189 renal parameters, except for renal medulla volume ( r=0.146, P=0.531), renal cortex volume ( r=0.784, P<0.001) and renal parenchyma volume ( r=0.698, P<0.001) were significantly correlated with GFR. The results of one-way ANOVA showed significant differences between the groups in terms of renal cortex volume ( F=142.62, P<0.001), renal parenchyma volume ( F=92.92, P<0.001), average CT value of the renal cortex ( F=12.68, P<0.001), average CT value of the renal parenchyma ( F=19.68, P<0.001), and renal medulla volume ( F=3.26, P=0.041). Significant differences were observed between the subgroups for both renal cortex and parenchyma volumes ( P<0.001). Compared with other parameters, renal cortex volume showed higher diagnostic performance in distinguishing different levels of renal function. When the renal cortex volume was set to 77.91 mL and 45.46 mL, respectively, the diagnostic performance for distinguishing normal renal function from mild renal impairment ( AUC=0.830, 95% CI: 0.761-0.889, P<0.001) and mild renal impairment from severe renal impairment ( AUC=0.894, 95% CI: 0.787-0.952, P<0.001) showed high sensitivity and specificity. Conclusions:The measurement of renal imaging parameters using 3D-slicer software has clinical value in evaluating renal function in patients. Renal cortex volume demonstrates good diagnostic performance in distinguishing different levels of renal function, and is worthy of clinical promotion and application.
