Clinical Application Study On 64-slice Spiral Computed Tomography Perfusion Imaging Technology Of Kidney Disease

objective: To investigate the scan methods and post-processing technology of 64-slice spiral CT, To investigate the various perfusion parameters on the clinical application value of kidney disease's diagnosis and differential diagnosis. Methods : Totally 40 patients meet the case criteria, 64-slice spiral CT was used for renal perfusion scan following a standard non-enhanced scan. Translating the data to GE AW4. 3 workstation , using CT Perfusion 3 software open the perfusion scan series, select kidney mode , set abdominal aorta for entered artery , sketch kidney cortex and the lesions interested in area regions of interest (ROI ), Calculate the time-density curve( Time-density Curve , TDC ) and tissues blood flow(BF) , blood volume (BV) ,mean transit time (MTT ) and permeability surface (PS) To observe the Sharp of TDC , Records every Group of BF,BV,MTT,and PS were expressed as the mean±standard deviation(SD) , Used SPSS 13.0 software to statistic a variety of perfusion parameters Mean±SD with the 2 paired-samples T test and the independent-samples T Test for data processing, To analysis the normal renal's cortex and medulla and the lesions'perfusion parameters changes in the value of the difference.Results: 40 patients, with no clear urinary system diseases in 12 cases , renal cell cancer in 8 cases for one - side, 1 cases of renal cyst, 10 patients with cirrhosis of liver, 9 cases of arterial hypertension, resulting in 24 cases of normal kidney perfusion parameters, can be used as a control group. Aortic TDC the pattern of TDC was single-peaked type, according to the time, the order is divided to 4 segments,the baseline,rising, falling and horizontal. Baseline was short, straight, and then a sharp peaks constructed by the ascending and descending segment appeared, with the highest amplitude, finally the flat segment kept slight and maintaining a long time. Renal cortex TDC as a single peak,also can be divided into to the baseline,rising,falling and horizontal segments. Base line is straight,more active duration is slightly longer,rising slope of the peak height below the aortic,then slowly drops,formed close to the high level segment of the aorta. Lesions of TDC group curve for single peak,can be divided to the baseline,rising,falling and horizontal segments,and peaks rise more slowly,and slightly smaller,less than or close to normal renal cortex,degree of decline quietly continued for the horizontal section of straight and lasted a long time,its height is below the normal renal cortex. Renal cortex's perfusion index of BF as control group is 456. 95±101. 81 mL·min-1·100g-1,BV is 4. 55±5. 64mL·100g-1,MTT is 4.51±1. 13s,PS is 63. 32±12. 10 mL·min-1·100g-1,Renal medullary's perfusion index of BF as control group is 133. 01±31. 33 mL·min-1·100g-1,BV is 11. 30±2. 53 mL·100g-1,MTT is 6.03±2. 03s,PS is 22. 26±10. 68 mL·min-1·100g-1,and the same on both sides of the kidneys,The BF,BV and PS averages and standard deviations of no significant difference.(P﹥0.05). Lesions of renal tumor group real BF is 84. 61±38. 5 mL·min-1·100g-1,BV is 11. 87±6. 49 mL·100g-1,MTT is 7. 44±3. 01s,PS is 28. 53±12. 97mL·min-1·100g-1,Cirrhosis group renal cortex's BF is 374. 47±45. 15 mL·min-1·100g-1,BV is 20. 95±1. 81 mL·100g-1,MTT is 5.59±0.92s,PS is 45.18±6. 23 mL·min-1·100g-1,Hypertensive renal cortex group BF is 339. 92±27. 18 mL·min-1·100g,BV is 18. 06±1. 49 mL·100g-1,MTT is 4. 23±0. 58s,PS is 57. 04±5. 65 mL·min-1·100g-1. the group between the BF,BV,MTT and PS have statistical differences (P﹤0. 05),Control group is the highest, Malignancy is the lowest. Conclusion : CTPI technologies is helpful to assess the blood flow and blood volume of Renal Cotex and Medullary, in from an evaluation on the renal function in many aspects, is an important medical imaging technology with a promising application prospect. In addition, CTPI can reflect with quantitative hemodynamic State, for renal tumor lesions, BF, BV and PS is less than the same - side residue renal cortex and the contralateral, The BF, BV of Cirrhosis and Hypertension group is lower than the control group, It has been a larger value to the diagnosis and differential diagnosis of kidney disease. In routine work of diagnosis, Conventional CT examine should be the Foundation, and TDC curve, the perfusion parameters and the psendo-color maps which could reflect hemodynamic status should be comprehensive analysis considered .