Abstract
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Objectives: To investigate the effect of the depth and depth difference of two kidneys measured by the rotation method on the measurement of total and fractional GFR by Gates method and its significance on renal dynamic imaging.
Methods: A total of 57 patients undergoing renal dynamic imaging and abdominal CT in our hospital were reviewed retrospectively. The depth and depth difference between the two kidneys were measured by CT, rotation(Figure 1), Tonnesen and Lee formula, and substituted into the Gates formula to obtain total kidney and divided kidney GFR. The values measured by CT were taken as the standard, the paired t-test was used to analyze the differences between the values measured by rotation, Tonnesen and Lee formula with CT. Bland-Altman test was used for consistency analysis. Pearson correlation analysis was performed on the difference in depth and the resulting changes in divided renal function.
Results: Compared with CT: ①Tonnesen formula underestimated the total kidney and divided kidney GFR, with statistically significant differences (total kidney: 61.84±22.13vs77.11±27.52, left kidney: 28.52±12.87vs35.93±15.92, right kidney: 33.32±13.82vs41.18±16.91; P< 0.05); There was no significant difference in the GFR of total kidney and divided kidney measured by Lee formula and rotation(total kidney: 78.24±26.86 76.62±27.02vs77.11±27.52, left kidney: 36.24±15.85 35.64±15.87vs35.93±15.92, right kidney: 41.99±16.99 40.98±17.25vs41.18±16.91; P> 0.05), and the consistency was good. Among them, the bias measured by rotation was the smallest. ②Tonnesen formula underestimated the depth of both kidneys, with statistically significant differences (left kidney: 5.97±0.89vs7.31±1.26, right kidney: 6.01±0.90vs7.28±1.16; P< 0.05); There was no significant difference in the depth of the two kidneys measured by Lee formula and rotation (left kidney: 7.40±1.18 7.26±1.28vs7.31±1.26, right kidney: 7.40±1.10 7.23±1.18vs7.28±1.16; P> 0.05), and the consistency was good. Among them, the bias measured by rotation was the smallest. ③Tonnesen and Lee formula underestimated the difference between the two kidney depths, and the difference was statistically significant (0.04±0.01 0.07±0.05vs0.41±0.33; P<0.05). There was no significant difference in the difference between the two kidney depths measured by rotation (0.48±0.36vs0.41±0.33, P>0.05).(Table 1) ④The depth difference was positively related to the changes in divided renal function (|R(CT) -R (Lee)|) and (|R(Rotation) -R(Lee)|) (R=0.967, 0.702, P<0.05)(Figure 2).As the depth difference increases, it is difficult for Lee formula to precisely show changes in divided renal function.
Conclusions: The accurate depth and depth difference of the two kidneys can be obtained by rotation method, so as to improve the accuracy of GFR measurement by Gates method.
Depth, depth difference and GFR value of two kidneys measured by four methods (x ± s)
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