Determination of Split Renal Function Using Dynamic CT-Angiography: Preliminary Results

作者：Helck Andreas^*; Schoenermarck Ulf; Habicht Antje; Notohamiprodjo Mike; Stangl Manfred; Klotz Ernst; Nikolaou Konstantin; la Fougere Christian; Clevert Dirk Andre; Reiser Maximilian; Becker Christoph

来源：PLos One, 2014, 9(3): e91774.

DOI：10.1371/journal.pone.0091774

Objectives: To determine the feasibility of a dynamic CT angiography-protocol with regard to simultaneous assessment of renal anatomy and function.
Methods: 7 healthy potential kidney donors (58 +/- 7 years) underwent a dynamic computed tomography angiography (CTA) using a 128-slice CT-scanner with continuous bi-directional table movement, allowing the coverage of a scan range of 18 cm within 1.75 sec. Twelve scans of the kidneys (n = 14) were acquired every 3.5 seconds with the aim to simultaneously obtain CTA and renal function data. Image quality was assessed quantitatively (HU-measurements) and qualitatively (grade 1-4, 1 = best). The glomerular filtration rate (GFR) was calculated by a modified Patlak method and compared with the split renal function obtained with renal scintigraphy.
Results: Mean maximum attenuation was 464 +/- 58 HU, 435 +/- 48 HU and 277 +/- 29 HU in the aorta, renal arteries, and renal veins, respectively. The abdominal aorta and all renal vessels were depicted excellently (grade 1.0). The image quality score for cortex differentiation was 1.6 +/- 0.49, for the renal parenchyma 2.4 +/- 0.49. GFR obtained from dynamic CTA correlated well with renal scintigraphy with a correlation coefficient of r = 0.84; P = 0.0002 (n = 14). The average absolute deviation was 1.6 mL/min. The average effective dose was 8.96 mSv.
Conclusion: Comprehensive assessment of renal anatomy and function is feasible using a single dynamic CT angiography examination. The proposed protocol may help to improve management in case of asymmetric kidney function as well as to simplify evaluation of potential living kidney donors.

• 出版日期2014-3-11