1
|
Belyaeva K, Rudenko V, Serova N, Morozov A, Taratkin M, Androsov A, Singla N, Shpunt I, Gomez Rivas J, Fajkovic H, Enikeev D, Kapanadze L. Kidney computed tomography perfusion in patients with ureteral obstruction. Urologia 2024; 91:486-493. [PMID: 38666713 DOI: 10.1177/03915603241244935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
INTRODUCTION Kidney perfusion on CT is an encouraging surrogate for renal scintigraphy in assessing renal function. However, data on dynamic volumetric CT in patients with kidney obstruction is lacking. Thus, the aim of this study is to determine the feasibility of CT-based renal perfusion using a dynamic volume to assess renal hemodynamics at different degrees and durations of obstruction. MATERIALS AND METHODS We included patients with unilateral kidney obstruction in our single-center, prospective study. The patients were divided into three groups. Patients without dilatation of the pelvicalyceal system (PCS) and normal parenchyma thickness were included into Group 1; patients with PCS dilatation and parenchyma thickness 1.8-2.4 cm-into Group 2; and patients with ureteropyelocalicoectasia and parenchyma thickness less than 1.8 cm-into Group 3. RESULTS Total of 56 patients were enrolled. In Group 1 mean values of cortical and medullar arterial blood flow, blood volume, and extraction fraction were within the normal range. Changes in contralateral kidney were not determined. Patients from Group 2 showed significant differences in blood flow parameters in the cortical and medulla of the obstructed kidney. No changes in perfusion values in the contralateral kidney was observed. In patients from Group 3 there was a marked decrease in perfusion on the side of obstruction compared to Group 2, indicating that the degree of expansion of the PCS directly correlates with the change in blood flow. However, in the contralateral kidney, these indicators exceeded the normal values of perfusion. CONCLUSION CT perfusion allows to objectively assess changes in blood flow in the setting of renal obstruction. The degree of obstruction directly affects the measured rate of blood flow.
Collapse
Affiliation(s)
- Ksenia Belyaeva
- Department of Radiation Diagnostics and Radiation Therapy, Faculty of Medicine, Sechenov University, Moscow, Russia
| | - Vadim Rudenko
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Natalya Serova
- Department of Radiation Diagnostics and Radiation Therapy, Faculty of Medicine, Sechenov University, Moscow, Russia
| | - Andrey Morozov
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Mark Taratkin
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | | | - Nirmish Singla
- Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Igal Shpunt
- Department of Urology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
| | - Juan Gomez Rivas
- Department of Urology, Clinico San Carlos University Hospital, Madrid, Spain
| | - Harun Fajkovic
- Department of Urology, Medical University of Vienna, Vienna, Austria
- Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
| | - Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
- Department of Urology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
- Department of Urology, Medical University of Vienna, Vienna, Austria
- Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
| | - Lida Kapanadze
- Department of Radiation Diagnostics and Radiation Therapy, Faculty of Medicine, Sechenov University, Moscow, Russia
| |
Collapse
|
2
|
Özatman E, Aksu B, Zemheri IE, Erman H, Durakbaşa ÇU. Investigation of reno-protective efficacy of thymoquinone in a unilateral hydronephrosis model. Biotech Histochem 2024:1-8. [PMID: 38780092 DOI: 10.1080/10520295.2024.2358034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
We aimed to evaluate the effects of the antioxidant thymoquinone on treated and untreated kidneys on histological and oxidative parameters as well as Kidney Injury Molecule (KIM-1) levels in an experimental unilateral ureteropelvic junction obstruction (UPJO) with resultant hydronephrosis (HN) model. In adherence to the Animal research: reporting of in vivo exepriments guidelines, 34 male Wistar rats were randomly divided into four groups which were named accordingly: "CO" (corn oil), "TQ" (thymoquinone and corn oil), "HNCO" (UPJO-HN and corn oil), "HNTQ" (UPJO-HN, thymoquinone and corn oil). Histologically, pelvic epithelial damage, glomerular shrinkage and sclerosis, tubular damage, interstitial edema-inflammation-fibrosis (IEIF), and vascular congestion were assessed. Biochemically, malondialdehyde (MDA), superoxide dismutase (SOD), glutathione reductase (GR) and KIM-1 levels were assessed. Macroscopic HN developed in all obstructed kidneys. Ipsilateral obstructed kidneys deteriorated in all histological parameters. Thymoquinone attenuated glomerular shrinkage and sclerosis alterations but increased vascular congestion. Contralateral non-obstructed kidneys also showed histological deterioration. Thymoquinone had beneficial effects in terms of IEIF presence in contralateral kidneys but it increased vascular congestion. MDA and SOD results were inconclusive. UPJO caused decreased GR levels in the ipsilateral kidneys but not in the contralateral ones. This effect was not ameliorated by thymoquinone treatment. KIM-1 levels were increased in ipsilateral obstructed kidneys with a lower level in HNTQ group than in HNCO. KIM-1 level of the ipsilateral HNTQ group was higher than in both non-obstructed ipsilateral kidney groups. The effect of thymoquinone in ameliorating bilaterally observed histological alterations was limited and controversial. Oxidative damage detected by GR measurements was not prevented by thymoquinone. Thymoquinone partially decreased the damage as evidenced by reduced KIM-1 levels in thymoquinone-treated obstructed kidneys.
Collapse
Affiliation(s)
- Erdem Özatman
- Department of Pediatric Surgery, Istanbul Medeniyet University Faculty of Medicine, Hospital, Prof. Dr. Suleyman Yalcin Sehir Hospital, Istanbul, Turkey
| | - Burhan Aksu
- Department of Pediatric Surgery, Istanbul Medeniyet University Faculty of Medicine, Hospital, Prof. Dr. Suleyman Yalcin Sehir Hospital, Istanbul, Turkey
| | - Itir Ebru Zemheri
- Department of Pathology, Saglik Bilimleri University Hamidiye Faculty of Medicine, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Hayriye Erman
- Department of Biochemistry, Istanbul Medeniyet University Faculty of Medicine, Prof. Dr. Suleyman Yalcin Sehir Hospital, Istanbul, Turkey
| | - Çiğdem Ulukaya Durakbaşa
- Department of Pediatric Surgery, Istanbul Medeniyet University Faculty of Medicine, Hospital, Prof. Dr. Suleyman Yalcin Sehir Hospital, Istanbul, Turkey
| |
Collapse
|
3
|
Wang C, Gao C, Maimaiti W, Li S, Yang Q, Jiang L. The features of technetium-99m-DTPA renal dynamic imaging after severe unilateral ureteral obstruction in adult rabbits. PLoS One 2020; 15:e0237443. [PMID: 32813713 PMCID: PMC7437917 DOI: 10.1371/journal.pone.0237443] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 07/27/2020] [Indexed: 11/22/2022] Open
Abstract
Background It is controversial to evaluate the function of hydronephrotic kidneys by renal dynamic imaging (RDI). Our aim was to study the features of renal dynamic imaging (RDI) at different stages after unilateral ureteral obstruction (UUO) and to investigate a method that could be reasonably used to evaluate renal function and predict renal functional recoverability. Methods We made UUO models using fifteen adult New Zealand white rabbits and systematically observed the changes in kidney morphology, blood flow, radiotracer distribution and function by RDI. We then compared the differences in terms of imaging features between different periods and analyzed the relationship between blood flow and function in obstructed kidneys. Results 1) Obstructed kidneys gradually became larger than preoperative kidneys and contralateral kidneys (P<0.05) and reached their peak size between days 42 and 56, after which they gradually got smaller in size. 2)The correlation between the blood perfusion of the obstructed kidney and the obstruction duration (r = 0.125, P = 0.045) was very weak. In the initial period of obstruction, the perfusion of the obstructed kidney significantly decreased, followed by a sharp rebound in later days, and then the perfusion declined again. The peak in blood perfusion was on day 7. 3) The uptake rate of the obstructed kidney drastically decreased in the early stage and became lower than that of the contralateral kidney and the kidney before the operation (P<0.05), after which uptake increased gradually; the peak was on day 28. After that, uptake gradually decreased. 4) The grading of the radiotracer distribution in obstructed kidneys was positively correlated with the obstruction duration (r = 0.975, P = 0.000), and a uniform renal distribution was an early feature of obstruction. 5) The blood perfusion of the obstructed kidney and its functioning frequently increased or decreased simultaneously, but sometimes there was also a mismatch. The peak of renal blood perfusion recovery occurred prior to the peak of renal function recovery. Conclusion In different periods of severe UUO, the imaged features of obstructed kidneys were different. These features are beneficial for determining the degree of hydronephrosis and renal function and predicting renal functional recoverability.
Collapse
Affiliation(s)
- Changyin Wang
- Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Chun Gao
- Second Clinical Faculty, Medical School of Wuhan University, Wuhan, Hubei, China
| | - Wasili Maimaiti
- Second Clinical Faculty, Medical School of Wuhan University, Wuhan, Hubei, China
| | - Shun Li
- Second Clinical Faculty, Medical School of Wuhan University, Wuhan, Hubei, China
| | - Qisheng Yang
- Emergency Center Surgical Department, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Linglong Jiang
- Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| |
Collapse
|
4
|
Liu D, Liu J, Wen Z, Li Y, Sun Z, Xu Q, Fan Z. 320-row CT renal perfusion imaging in patients with aortic dissection: A preliminary study. PLoS One 2017; 12:e0171235. [PMID: 28182709 PMCID: PMC5300209 DOI: 10.1371/journal.pone.0171235] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 01/17/2017] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To investigate the clinical value of renal perfusion imaging in patients with aortic dissection (AD) using 320-row computed tomography (CT), and to determine the relationship between renal CT perfusion imaging and various factors of aortic dissection. METHODS Forty-three patients with AD who underwent 320-row CT renal perfusion before operation were prospectively enrolled in this study. Diagnosis of AD was confirmed by transthoracic echocardiography. Blood flow (BF) of bilateral renal perfusion was measured and analyzed. CT perfusion imaging signs of AD in relation to the type of AD, number of entry tears and the false lumen thrombus were observed and compared. RESULTS The BF values of patients with type A AD were significantly lower than those of patients with type B AD (P = 0.004). No significant difference was found in the BF between different numbers of intimal tears (P = 0.288), but BF values were significantly higher in cases with a false lumen without thrombus and renal arteries arising from the true lumen than in those with thrombus (P = 0.036). The BF values measured between the true lumen, false lumen and overriding groups were different (P = 0.02), with the true lumen group having the highest. Also, the difference in BF values between true lumen and false lumen groups was statistically significant (P = 0.016), while no statistical significance was found in the other two groups (P > 0.05). The larger the size of intimal entry tears, the greater the BF values (P = 0.044). CONCLUSIONS This study shows a direct correlation between renal CT perfusion changes and AD, with the size, number of intimal tears, different types of AD, different renal artery origins and false lumen thrombosis, significantly affecting the perfusion values.
Collapse
Affiliation(s)
- Dongting Liu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jiayi Liu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhaoying Wen
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yu Li
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhonghua Sun
- Department of Medical Radiation Sciences, Curtin University, Perth, Australia
| | - Qin Xu
- School of Public Health, Capital Medical University, Beijing, China
| | - Zhanming Fan
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- * E-mail:
| |
Collapse
|
5
|
Cai XR, Zhou QC, Yu J, Feng YZ, Xian ZH, Yang WC, Mo XK. Assessment of renal function in patients with unilateral ureteral obstruction using whole-organ perfusion imaging with 320-detector row computed tomography. PLoS One 2015; 10:e0122454. [PMID: 25874690 PMCID: PMC4398441 DOI: 10.1371/journal.pone.0122454] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 02/11/2015] [Indexed: 12/02/2022] Open
Abstract
Background Obstructed nephropathy is a common complication of several disease processes. Accurate evaluation of the functional status of the obstructed kidney is important to achieve a good outcome. The purpose of this study was to investigate renal cortical and medullary perfusion changes associated with unilateral ureteral obstruction (UUO) using whole-organ perfusion imaging with 320-detector row computed tomography (CT). Methodology/Principle Findings Sixty-four patients with UUO underwent whole-organ CT perfusion imaging. Patients were divided into 3 groups, mild, moderate, and severe, based on hydronephrosis severity. Twenty sex- and age-matched patients without renal disease, who referred to abdominal CT, were chosen as control subjects. Mean cortical and medullary perfusion parameters of obstructed and contralateral kidneys were compared, and mean perfusion ratios between obstructed and contralateral kidneys were calculated and compared. Mean cortical or medullary blood flow (BF) and blood volume (BV) of the obstructed kidneys in the moderate UUO and BF, BV, and clearance (CL) in the severe UUO were significantly lower than those of the contralateral kidneys (p < 0.05). The mean cortical or medullary BF of the obstructed kidney in the moderate UUO, and BF, BV, and CL in the severe UUO were significantly lower than those of the kidneys in control subjects (p < 0.05). Mean cortical or medullary BF of the non-obstructed kidneys in the severe UUO were statistically greater than that of normal kidneys in control subjects (p < 0.05). An inverse correlation was observed between cortical and medullary perfusion ratios and grades of hydronephosis (p < 0.01). Conclusions/Significance Perfusion measurements of the whole kidney can be obtained with 320-detector row CT, and estimated perfusion ratios have potential for quantitatively evaluating UUO renal injury grades.
Collapse
Affiliation(s)
- Xiang-Ran Cai
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, P.R.China
- * E-mail:
| | - Qing-Chun Zhou
- Department of Urology, Nanhua Affiliated Hospital, Nanhua University, Hengyang, Hunan, P.R.China
| | - Juan Yu
- Department of Radiology, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, P.R.China
| | - You-Zhen Feng
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, P.R.China
| | - Zhao-Hui Xian
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, P.R.China
| | - Wen-Cai Yang
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, P.R.China
| | - Xu-Kai Mo
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, P.R.China
| |
Collapse
|
6
|
Chen C, Liu Q, Hao Q, Xu B, Ma C, Zhang H, Shen Q, Lu J. Study of 320-slice dynamic volume CT perfusion in different pathologic types of kidney tumor: preliminary results. PLoS One 2014; 9:e85522. [PMID: 24465588 PMCID: PMC3897451 DOI: 10.1371/journal.pone.0085522] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 11/27/2013] [Indexed: 12/18/2022] Open
Abstract
Objective To investigate microcirculatory differences between pathologic types of kidney tumor using 320-slice dynamic volume CT perfusion. Methods Perfusion imaging with 320-slice dynamic volume CT was prospectively performed in 85 patients with pathologically proven clear cell renal cell carcinoma (RCC) (n = 66), papillary RCC (n = 7), chromophobe RCC (n = 5), angiomyolipoma (AML) with minimal fat (n = 7), or RCC (n = 78). Equivalent blood volume (Equiv BV), permeability surface-area product (PS; clearance/unit volume = permeability), and blood flow (BF) of tumor and normal renal cortex were measured and analyzed. Effective radiation dose was calculated. Results There was a significant difference in all three parameters between tumor and normal renal cortex (P<0.001). Equiv BV was significantly different between RCC and AML with minimal fat (P = 0.038) and between clear cell RCC and AML with minimal fat (P<0.001). Mean Equiv BV and BF were significantly higher in clear cell RCC than in papillary RCC (P<0.001 for both) and mean Equiv BV was higher in clear cell RCC than in chromophobe RCC (P<0.001). The effective radiation dose of the CT perfusion protocol was 18.5 mSv. Conclusion Perfusion imaging using 320-slice dynamic volume CT can be used to evaluate hemodynamic features of the whole kidney and kidney tumors, which may be useful in the differential diagnosis of these four pathologic types of kidney tumor.
Collapse
Affiliation(s)
- Chao Chen
- Department of Radiology, Changhai Hospital of Shang hai, The second Military Medical University, Shanghai, China
| | - Qi Liu
- Department of Radiology, Changhai Hospital of Shang hai, The second Military Medical University, Shanghai, China
| | - Qiang Hao
- Department of Radiology, Changhai Hospital of Shang hai, The second Military Medical University, Shanghai, China
| | - Bing Xu
- Department of Radiology, Changhai Hospital of Shang hai, The second Military Medical University, Shanghai, China
| | - Chao Ma
- Department of Radiology, Changhai Hospital of Shang hai, The second Military Medical University, Shanghai, China
| | - Huojun Zhang
- Department of Radiology, Changhai Hospital of Shang hai, The second Military Medical University, Shanghai, China
| | - Qianjin Shen
- Department of Radiology, Changhai Hospital of Shang hai, The second Military Medical University, Shanghai, China
| | - Jianping Lu
- Department of Radiology, Changhai Hospital of Shang hai, The second Military Medical University, Shanghai, China
- * E-mail:
| |
Collapse
|