Qhov cuam tshuam ntawm Kev Ntsuas Kev Sib Nraus Raum Ua Haujlwm Rau Tom Qab Pub Rau Raum Ua Haujlwm: Kev Tshawb Fawb Txog Kev Tshawb Fawb
Mar 21, 2022
Kelly C. Harper et al
Abstract
Keeb kwm
Cov kev tshawb fawb tau tshaj tawm kev pom zoo ntawm kev suav tomography (CT) thiab renography rau kev txiav txim siab ntawm kev sib caisraummuaj nuj nqi. Txawm li cas los xij, lawv txoj kev sib raug zoo nrog kev pub dawb tom qabraumkev ua haujlwm tseem tsis meej. Peb piv CT ntsuas nrog renography hauv kev ntsuam xyuas ntawm kev sib caisraumkev ua haujlwm (SKF) thiab lawv cov kev sib raug zoo nrog kev ua haujlwm tom qab pub rau lub raum.
Cov txheej txheem
Ib qhov chaw ib-chaw, kev tshawb fawb rov qab los ntawm 248 tus neeg pub dawb los ntawm Lub Ib Hlis 1, 2009-Lub Xya Hli 31, 2019 raug soj ntsuam. Pearson correlations tau siv los ntsuam xyuas tom qab pub dawbraumua haujlwm nrog renography thiab CT-based ntsuas. Tsis tas li ntawd, peb tau tshuaj xyuas cov pab pawg uas muaj kev pheej hmoo siab nrog SKF qhov sib txawv ntau dua 10 feem pua ntawm renography thiab cov neeg pub dawb nrog cov nyiaj pub dawb tom qab GFR tsawg dua 60 mL / min / 1.73m2.
Cov txiaj ntsig
62 feem pua ntawm cov neeg pub dawb yog cov poj niam uas muaj qhov sib txawv (tus qauv sib txawv) ua ntej pub dawb eGFR 99 (20) thiab tom qab pub dawb eGFR 67 (22) mL / min / 1.73m2 ntawm 31 lub hlis tom qab. Tom qab pub dawbraumkev ua haujlwm tsis zoo cuam tshuam nrog ob qho tib si CT-raws li kev ntsuas thiab renography, suav nrog cov pab pawg ntawm cov neeg pub dawb nrog cov nyiaj pub dawb tom qab eGFR tsawg dua 60 mL/min/1.73m2 (tsawg dua 0.4 rau txhua tus) . Muaj kev pom zoo ntawm CT-raws li kev ntsuas thiab renography rau SKF kev txiav txim siab (Bland-Altman daim ntawv cog lus [kev tsis ncaj ncees, 95 feem pua ntawm kev pom zoo] duab liab qab vs: CT ntim, 0.76 feem pua , -7.60– 9.15%. Txawm li cas los xij, CT plam SKF ntau dua 10 feem pua pom pom renography hauv 20 tawm 26 (77 feem pua) ntawm cov neeg pub dawb.
Cov lus xaus
Nyob rau hauv ib lub chaw kawm ib leeg ntawm 248 tus neeg pub dawb nyob, peb pom tsis muaj kev sib raug zoo ntawm CT lossis renography thiab tom qab pub dawb eGFR. Kev tshawb fawb ntxiv yog xav tau los txiav txim siab txoj hauv kev zoo los kwv yees qhov seemraumua haujlwm tom qab pub dawb.
Hu rau: ali.ma@wecistanche.com
Taw qhia
nyob pubraumtransplantation muab cov neeg mob zoo dua thiab graft ciaj sia rau cov neeg mob nrograumtsis ua hauj lwm piv nrog cov neeg tuag pub raum hloov pauv [1,2]. Txawm li cas los xij, tus naj npawb ntawm cov neeg nyob hauv lub raum hloov pauv tau tseem tsis hloov pauv txij li xyoo 2008 thaum qhov kev xav tau tau nce ntxiv hauv Canada, txawm tias muaj pes tsawg tus neeg nyob.raumkev hloov pauv tau nce hauv lwm lub tebchaws [3–5]. Cov txheej txheem ntsuam xyuas yuav tsum muaj rau kev pub rau lub raum nyob yog kim thiab siv sij hawm, yuav tsum tau kuaj ntau thiab ntau yam kev mus ntsib. Cov neeg mob raum tau hais txog qhov yooj yim ntawm cov txheej txheem kev ntsuam xyuas tus neeg pub dawb yog qhov tseem ceeb. Ua li no tuaj yeem txhais ua ntau ntxiv ntawm kev hloov pauv rau lub raum nyob, ua rau kev tshawb nrhiav ntawm kev kuaj tsis tu ncua thiab kev ua haujlwm ntawm cov neeg sib tw pub dawb [6].
Abdominal computerized tomography (CT) yog ua raws li ib feem ntawm kev ua haujlwm pub dawb nyob hauv cov neeg muaj peev xwm pub dawb los soj ntsuam cov vasculature, pab nrog kev npaj phais, thiab tsis suav nrog cov kev tshawb pom thiab lub cev tsis zoo rau kev hloov pauv. Split raum kev ua haujlwm kuaj kuj tseem pab qhia kev xaiv covraumrau kev hloov pauv, nrog rau kev nyiam tawm ntawm tus neeg pub dawb nrog lub raum ua haujlwm siab dua. Kev ntsuas qhov loj ntawm txhua lub raum tau ua nrog cov lus pom zoo tam sim no qhia tias nuclear renography (renography) yuav tsum tau ua los txiav txim siab txog kev ua haujlwm ntawm txhua lub raum (piv txwv li cais lub raum ua haujlwm) tsuas yog hauv cov neeg mob uas muaj qhov sib txawv ntawm lub raum ntev tshaj 1 cm ntawm CT [7,8. ]. Txawm li cas los xij, nws tsis paub meej yog tias txoj kev no ib leeg yuav tsum tau txais los ntawm txhua tus neeg pub dawb cov kev pab cuam uas tsis muaj cov ntaub ntawv mus sij hawm ntev ntawm lawv lub peev xwm los kwv yees tom qab pub dawb.raumua haujlwm [9–14]. Qhov no yog ib qho kev txhawj xeeb tshwj xeeb rau cov neeg pub dawb uas muaj qhov sib txawv tseem ceeb hauv kev sib cais ntawm lub raum kev ua haujlwm ntawm renography uas ploj lawm ntawm CT thiab cov neeg pub dawb uas tsis tshua muaj eGFR tom qab pub dawb. Ntau lub tsev kawm ntawv Canadian tseem ua renography hauv txhua tus neeg muaj peev xwm pub dawb, suav nrog cov kev ntsuas ib hnub ntawm cov neeg sib tw pub dawb [8,15]. Peb lub koom haum yog nyob rau hauv pab pawg no, tam sim no rov tshuaj xyuas peb qhov kev coj ua, uas yog li muab peb cov neeg coob, tsis sib law liag thiab cov ntaub ntawv los ntawm xyoo tas los no.
Lub hom phiaj ntawm peb txoj kev tshawb fawb yog los txiav txim seb CT-raws li kev ntsuas thiab renography tuaj yeem kwv yees tom qab pub dawbraummuaj nuj nqi. Peb tau soj ntsuam tshwj xeeb ntxiv rau cov tib neeg muaj kev pheej hmoo siab nrog rau lub raum ua haujlwm ntawm ntau dua 10 feem pua ntawm renography. Peb xav tias CT-raws li kev ntsuas yuav sib npaug rau qhov kev ntsuas renography-raws li kev sib cais.raummuaj nuj nqi thiab kwv yees tom qab pub dawb raum ua haujlwm.
Cov ntaub ntawv thiab cov txheej txheem
Cov txheej txheem kawm tau pom zoo los ntawm Lub Tsev Kho Mob Ottawa Health Science Network Tshawb Fawb Kev Ncaj Ncees Pawg Thawj Coj (Txoj Cai ID 20190489-01H) thiab tau muab tso rau hauv Open Science Framework. Txoj kev tshawb no tau tshaj tawm raws li Kev Txhim Kho Kev Tshaj Tawm Txog Kev Tshawb Fawb Kev Tshawb Fawb hauv Kev Kab Mob Kab Mob (STROBE) cov lus qhia (S1 Table hauv S1 Cov Ntaub Ntawv) [16]. Tus neeg mob tus cim tau siv rau kev sau cov ntaub ntawv tab sis tom qab ntawd tshem tawm ntawm qhov kev tshuaj ntsuam. Cov neeg mob cov ntaub ntawv kho mob tau nkag los ntawm Lub Kaum Hli 2019 txog Lub Cuaj Hli 2020 thiab tsis muaj kev kho mob los ntawm cov neeg mob. Lub Tsev Kho Mob Ottawa Kev Tshawb Fawb Txog Kev Ncaj Ncees tau zam qhov xav tau kev tso cai pom zoo rau txoj kev tshawb fawb no. Cov ntaub ntawv muaj peev xwm txheeb xyuas tus neeg mob cov ntaub ntawv tseem ceeb thiab tsuas yog muaj los ntawm Ottawa Health Science Network Research Ethics Board (www.ohri.ca/ohsn-reb, Civic Box 675, 725 Parkdale Avenue, Ottawa, Ontario K1Y 4E9 613-798-5555 ext. 16719 Fax: 613-761-4311) rau cov kws tshawb fawb uas ua tau raws li cov txheej txheem rau kev nkag mus rau cov ntaub ntawv tsis pub lwm tus paub.
Peb tau ua ib qho kev tshawb fawb rov qab los ntawm txhua qhov kev ua neej sib law liagraumpub dawb hauv lub neejLub raumKev Pab Nyiaj pub dawb ntawm Lub Tsev Kho Mob Ottawa, lub tsev kho mob tertiary, txij lub Ib Hlis 1, 2009, txog rau Lub Xya Hli 31, 2019. Txhua tus neeg pub dawb hauv peb qhov kev pab cuam nyob rau lub raum pub dawb tau txais kev kho mob nuclear, ntxiv rau CT. Tus neeg pub dawb cov ntaub ntawv pej xeem,raumpub dawb (sab laug rau sab xis), ua ntej thiab tom qab pub dawb creatinine, hnub ntsuas, thiab kwv yees glomerular filtration rate (eGFR) los ntawm Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation tau sau los ntawm cov ntaub ntawv kho mob hauv hluav taws xob. Peb lub chaw yuav tsum muaj 2 qhov kev kwv yees sib cais ntawm GFR ua ntej pub dawb thiab tsis txwv kev ntsuas GFR ncaj qha, raws li Canadian cov lus qhia [8]. Txhua tus neeg pub dawb nrog cov duab tsim nyog muaj, suav nrog cov duab thaij duab ntawm lwm lub tsev kawm ntawv, tau suav nrog. Cov neeg pub dawb raug cais tawm yog tias CT thiab nuclear renogram tau ua tiav ntau dua 3 lub hlis sib nrug, yog tias cov txiaj ntsig tsis muaj, lossis yog tias kev thaij duab tsis sib haum nrog cov duab kos duab thiab kev sib txuas lus (PACS) (McKesson Technology Systems, GA, USA) lossis Hermes workstations (Hermes Medical Solutions, Stockholm, Sweden). Tsis tas li ntawd, cov neeg pub dawb raug cais tawm yog tias lawv muaj cov kab kos tsis tiav, txhais tau tias tsis muaj cov ntshav creatinine, hnub pub dawb, lossis kev mus ntsib tom qab.
Nuclear renography thiab CT-based ntsuas
Txhua tus neeg pub nyiaj tau txais kev ntsuas rov qab los ntawm kev ntsuas nuclear. Lub cheeb tsam ntawm kev txaus siab ntawm txhua tusraumtau kos manually los tsim ib lub sij hawm-kev ua haujlwm nkhaus ntawm cov duab. Cov cheeb tsam ntawm lub sijhawm ua haujlwm nkhaus tau txiav txim siab faib ua haujlwm ntawm txhua lub raum ntawm 1-3 feeb. Nuclear renography ntawm peb lub tsev kawm ntawv yuav tau pib ua nrog 259–370 MBq(7.0–10.0 mCi) ntawm technetium-labeled diethylenetriaminepentacetate (Tc99m-DTPA) scan lossis technetium-labeled mercaptoacetyltclycly9 -MAG 3). Dynamic dluab ntawm lub posterior lossis anterior thiab posterior plab mog tau ua nrog ob lub taub hau ECAM scanner (Siemens Medical Solutions, USA) rau 30 feeb.
Peb qhov kev ntsuas rov qab CT-raws li tau txais: i) ob-dimensional craniocaudal (CC) dimension ii) ob-dimensional hloov ellipsoid ntim thiab iii) peb-dimensional ntim. Ob-dimensional CT ntsuas tau txais ntawm PACS software nrog kev tswj xyuas cov duab los muab kev taw qhia oblique rawslub cevtseeb ntev axis. Hloov kho ellipsoid ntim tau suav ntim ntim=ntev x dav x thickness x (pi/6) raws li Soga li al. kom tso cai ntim qhov ntsuas los ntawm 2D ntsuas, xav tau craniocaudal (ntev), anterolateral (dav), thiab anteroposterior (thickness) ntsuas [17]. Peb-dimensional CT volumetry tau ua nrog AquariusNET software (TeraRecon, Foster-City, California) siv semi-automated contouring nrog kev cais tawm ntawm cov qauv nyob ib puag ncig, suav nrog vasculature thiab kev sau cov tshuab. Kev ntsuas CT tau txais nyob rau theem corticomedullary nyob qhov twg. Yog tias tsis muaj, cov theem arterial tau nyiam siv tshaj qhov tsis sib xws ntawm cov duab thaij duab los muab kev daws teeb meem ntau ntxiv ntawm cov ntaub so ntswg uas nyob ib sab.
Ob tus neeg tshawb nrhiav (cov neeg nyob hauv lub xyoo thib peb kuaj mob hluav taws xob, KH thiab NA) tau ua txhua yam kev ntsuas kev ntsuas ntawm nws tus kheej los txiav txim siab qhov kev pom zoo ntawm kev sib tw. Ib tus neeg soj ntsuam (KH) tau ua qhov ntsuas ob zaug rau kev pom zoo hauv kev sib tw, nrog rau lub sijhawm tsawg kawg ib lub lim tiam ntawm kev ntsuas. Cov kws tshawb nrhiav tau ua qhov muag tsis pom kev rau kev ntsuas ua ntej lossis ib qho txiaj ntsig kho mob.
Kev ntsuas phua lub raum ua haujlwm
Sib caisraummuaj nuj nqi raug xam raws li txoj cai rho tawm sab laugraum(sab xis-sab laug) rau tag nrho cov qauv duab. Nuclear renography ntsuas yog qhia raws li feem pua ua haujlwm raws li scintigraphic integral method inference. Sib caisraumKev ua haujlwm los ntawm CT-raws li kev ntsuas tau xav tias tus neeg lub raum ua haujlwm rau lub raum tag nrho yog qhov sib npaug rau qhov loj thiab suav los ntawm kev hloov cov kev ntsuas mus rau feem pua raws li qhov sib npaug (txoj cai-sab laug) / (txoj cai ntxiv rau sab laug) x100 feem pua. Qhov ntau dua 10 feem pua ntawm qhov sib txawv ntawm txoj cai thiab sab laug faib lub raum ua haujlwm tau suav tias yog qhov tseem ceeb hauv kev kho mob [7,9,10]
CT thiab renography-raws li kev kwv yees ntawm lub raum ua haujlwm ntxiv tom qab pub raum
Cov neeg mob uas muaj tsawg kawg yog 6 lub hlis tom qab cov ntaub ntawv pub dawb muaj, tshwj xeeb CKD-EPI eGFR, tau txheeb xyuas. Kev kwv yees tom qab pub dawb eGFR tau suav tias ua ntej pub dawb eGFR x feem pua pivraumkev ua haujlwm ntawm qhov khaws ciaraumrau txhua tus qauv. Kev sib raug zoo ntawm kev kwv yees thiab pom tom qab pub dawb eGFR tau txiav txim siab siv Pearson qhov sib txheeb coefficient rau txhua tus neeg pub dawb thiab pab pawg neeg pub dawb uas tsis tshua muaj eGFR (tsawg dua 60 mL / min / 1.73m2 ). Correlation coefficient tau txhais raws li hauv qab no:<0.3 negligible,="" 0.3–0.5="" low,="" 0.5–0.7="" moderate,="" 0.7–0.9="" high,="" and="" 0.9–1.0="" very="" high="" correlation="">
Cov neeg pub dawb nrog rau lub raum ua haujlwm ntau dua 10 feem pua ntawm cov khoom siv hluav taws xob nuclear
Cov neeg pub dawb nrog kev sib caisraumKev ua haujlwm sib txawv ntawm ntau dua 10 feem pua ntawm renography tau txheeb xyuas. Lawvraumpub pub dawb thiab tom qab pub nyiaj pub dawb ntxiv rau lub raum ua haujlwm ntawm kev soj ntsuam zaum kawg tau txiav txim siab. Cov neeg pub dawb hauv pab pawg no raug kuaj xyuas kom muaj kev sib caisraumkev ua haujlwm sib txawv ntawm ntau dua 10 feem pua ntawm renography uas tsis pom ntawm ib qho kev ntsuas CT.
Daim ntawv cog lus thiab rov tsim dua tshiab ntawm CT thiab nuclear renography ntsuas
Bland-Altman tsom xam tau siv los ntsuas qhov kev pom zoo ntawm txhua qhov CT-raws li kev ntsuas ntawm kev sib cais.raummuaj nuj nqi thiab renography. Intra- thiab inter-rater kev pom zoo ntawm CT thiab renography ntsuas tau ua los ntawm kev ntsuas kev sib raug zoo hauv chav kawm (ICC). Daim ntawv cog lus intra-rater tau suav nrog siv tus nqi nruab nrab rau tus nyeem ntawv (KH) nrog ob qhov kev ntsuas ntsuas thiab cov ntawv cog lus inter-rater tau suav nrog siv thawj tus nyeem ntawv ob qhov kev ntsuas. ICC qhov tseem ceeb tau txhais raws li hauv qab no:<0.5 poor,="" 0.5–0.75="" moderate,="" 0.75–0.9="" good,="" and="">0.90 kev ntseeg tau zoo heev [19].
Kev txheeb cais
Cov yam ntxwv hauv paus thiab cov txiaj ntsig tau raug nthuav tawm raws li txhais tau tias (± tus qauv sib txawv, SD) rau qhov sib txawv tsis tu ncua thiab zaus (feem pua) rau categorical variables. Statistical tseem ceeb tau txhais raws li ob sab p<0.05. all="" statistical="" analyses="" were="" performed="" in="" r="" (r="" foundation="" for="" statistical="" computing,="" vienna,="">
Cov txiaj ntsig
Ob puas thiab cuaj caum-ib nyob sib law liagraumcov neeg pub nyiaj raug txheeb xyuas. 248 tus neeg pub dawb muaj ob qho tib si CT thiab nuclear renography imaging muaj thiab 243 tus neeg pub dawb muaj tom qab pub dawb eGFR muaj (Fig 1). 154 (62 feem pua) yog poj niam thiab 219 (88 feem pua) Caucasian. Qhov nruab nrab (SD) hnub nyoog ntawm kev pub dawb yog 48 (13) xyoo thiab lub sijhawm ntawm kev rov qab los tom qab pub dawb yog 31 (21) lub hlis (Table 1). Qhov nruab nrab (SD) pub dawb ua ntej yog eGFR 99 (20) mL/min/1.73m2 thiab tom qab pub dawb eGFR 67 (22) mL/min/1.73m2. Lub raum sab laug tau muab pub rau hauv 222 tus neeg pub dawb (89 feem pua). 227 (93 feem pua) cov neeg pub dawb tau txais nyiaj pub dawb tom qab CKD-EPI eGFR muaj tsawg kawg yog 6 lub hlis tom qab pub dawb.96 (40 feem pua) ntawm cov neeg pub dawb muaj eGFR tom qab pub dawb tsawg dua 60 mL/min/1.73m2.
CT thiab renography-raws li kev kwv yees ntawm lub raum ua haujlwm ntxiv tom qab pub raum
Kev sib raug zoo ntawm kev kwv yees eGFR nrog kev pom tom qab pub dawb eGFR hauv tag nrho plaub qhov kev ntsuas ntsuas (nuclear renography, CT ntim, hloov kho ellipsoid, CC dimension) tau piav qhia hauv daim duab 2A-2D rau txhua tus neeg pub dawb nrog tsawg kawg 6 lub hlis tom qab. , n=227 (93 feem pua). Muaj kev sib raug zoo tsis txaus ntseeg rau tag nrho 3 CT-raws li kev ntsuas thiab qhov tsis sib xws ntawm renography. Ntawm cov pab pawg ntawm cov neeg pub dawb uas tsis ntev los no eGFR tsawg dua 60 mL/min/1.73m2, n=96 (40 feem pua) (Daim duab 3A-3D), muaj qhov tsis txaus ntseeg sib raug rau tag nrho 3 CT -raws li kev ntsuas thiab kev sib raug qis rau renography.
Cov neeg pub dawb nrog rau lub raum ua haujlwm ntau dua 10 feem pua ntawm cov khoom siv hluav taws xob nuclear
Nees nkaum rau (11 feem pua) cov neeg pub dawb muaj ntau dua 10 feem pua ntawm qhov sib caisraumkev ua haujlwm raws li kev hloov pauv hauv nuclear uas tau ploj los ntawm tsawg kawg yog 1 CT-raws li kev ntsuas hauv 20 (77 feem pua) cov neeg pub dawb (Table 2). Ntawm 26 tus neeg pub dawb no, 9 (35 feem pua) tau pub lawv cov haujlwm ntau duaraum(Table 3). 6 (23 feem pua) ntawm 26 tus neeg pub dawb muaj eGFR tsawg dua 60 ml / min / 1.73m2ntawm qhov nruab nrab ntawm kev rov qab los ntawm kev pub dawb rau feem ntau tsis ntev los no tom qab pub dawb eGFR ntsuas ntawm 37 ± 22 lub hlis (Table 3). Tsuas yog 1 ntawm 6 tus neeg pub dawb uas pub lawv cov haujlwm siab duaraummuaj eGFR tsawg dua 60 mL / min / 1.73m2ntawm 53 lub hlis tom qab pub dawb. Ntawm 9 (35 feem pua) cov neeg pub dawb uas pub lawv cov haujlwm ntau duaraum, qhov nruab nrab pub dawb eGFR yog 101 mL / min / 1.73m2thiab tom qab pub dawb eGFR yog 71 mL / min / 1.73m2thaum nyob rau hauv 17 tus neeg pub dawb uas pub lawv cov haujlwm qis duaraumQhov nruab nrab pub dawb yog 98 mL / min / 1.73m2 thiab lub ntsiab lus tom qab pub dawb yog 72 mL / min / 1.73m2. Zuag qhia tag nrho, qhov nruab nrab eGFR poob qis rau cov neeg uas pub lawv cov haujlwm siab duaraumyog 30 mL/min/1.73m2thiab rau cov uas pub lawv cov haujlwm qis duaraumyog 26 mL/min/1.73m2.
Cov neeg pub dawb nrog kev pub dawb tom qab eGFR<60>2
96 ntawm 243 tus neeg pub dawb nrog qhov muaj tom qab pub dawb eGFR (40 feem pua) muaj cov nyiaj pub dawb tom qab eGFR ntawm tsawg dua 60 mL / min / 1.73m2 ntawm qhov kev soj ntsuam zaum kawg, nrog qhov txhais tau tias (SD) ua raws li 28 (27) hli. Qhov nruab nrab (SD) pub dawb eGFR ntawm pab pawg no yog 90 (25) mL / min / 1.73m2 thiab tshaj tawm yog 51 (6) mL / min / 1.73m2. 39 (41 feem pua) ntawm 96 tus neeg mob no tau pub lawv cov haujlwm ntau duaraumthiab lawv qhov nruab nrab (SD) pub dawb eGFR yog 89 (28) mL/min/1.73m2 thiab tom qab pub dawbGFR yog 49 (7) mL/min/1.73m2. Kev faib lub raum ua haujlwm ntawm ntau dua 10 feem pua ntawm cov renography tsuas yog pom hauv 7 tus neeg pub dawb, 2 ntawm lawv tau txheeb xyuas los ntawm 1 lossis ntau dua CT-raws li kev ntsuas.
Daim ntawv cog lus thiab rov tsim dua tshiab ntawm CT thiab nuclear renography ntsuas
Bland-Altman kev pom zoo ntawm nuclear renography thiab CT ntsuas (txhais tau tias tsis ncaj ncees lawm, 95 feem pua txwv kev pom zoo) rau renography vs: CT ntim, 0.76 feem pua , -7.60–9.15 feem pua; hloov kho ellipsoid, 1.01 feem pua , {{10}}.38–1{{30}}.42 feem pua ; CC dimension, 0.44 feem pua , -7.06–7.94 (Fig 4A-4C). Intra-rater pom zoo-ment yog zoo heev rau nuclear renography (ICC {{40}}}.92). Intra-rater pom zoo yog nruab nrab rau CT-raws li kev ntsuas: ntim, ICC 0.6; hloov kho ellipsoid, ICC 0.57; thiab craniocaudal dimension, ICC 0.66. Muaj kev pom zoo inter-rater pom zoo rau nuclear renography (ICC 0.86) thiab kev pom zoo me me rau CT-raws li kev ntsuas: ntim, ICC 0.64; hloov ellip soid, ICC 0.64; thiab craniocaudal dimension, ICC 0.72 (Table 4).
Kev sib tham
Nyob rau hauv no loj pawg ntawm kev nyobraumCov neeg pub dawb, tsis yog CT-raws li kev ntsuas lossis renography kwv yeesraumua haujlwm ntawm qhov nruab nrab ntawm 31 lub hlis tom qab pub dawb ua raws. Tsis tas li ntawd, qhov no tau zoo ib yam ntawm cov neeg pom tias muaj kev pheej hmoo kho mob siab nrog rau lub raum faib ua haujlwm ntau dua 10 feem pua ntawm renography lossis eGFR< 60="" ml/min="" post-donation.="" lastly,="" despite="" a="" high="" level="" of="" ct="" and="" nuclear="" renography="" for="" skf="" measures,="" a="" surprising="" ct="" missed="" a="" clinically="" significant="" split="" kidney="" function="" difference="" found="" by="" renography="" in="" 20="" out="" 26="" (77%)="" of="">
Renography yog ib txwm siv nyob rau hauv ntau qhov kev pabcuam pub dawb vim muaj kev txhawj xeeb ntawm kev ploj lawm qhov chaw kho mob tseem ceeb hauv kev sib cais.raumkev ua haujlwm nrog qhov kev txhawj xeeb kawg ntawm tus neeg pub dawb uas tsis tshua muaj txiaj ntsig tom qab pub dawb raum ua haujlwm tsawg dua 60 mL / min / 1.73 m2. Hauv peb txoj kev tshawb fawb, tsis muaj CT-raws li kev ntsuas lossis renography kwv yees tom qab pub dawb eGFR hauv pawg pab pawg kho mob no. Cov neeg mob feem ntau tsis muaj qhov sib txawv tseem ceeb hauv kev ua haujlwm ntawm lub raum los ntawm kev ntsuas renography lossis CT-raws li kev ntsuas, tab sis qee tus neeg pub dawb tau pom tias muaj qhov sib txawv ntawm cov renography uas CT yuav tsis tau. Cov chaw kho mob muaj feem cuam tshuam nrog qhov sib txawv tseem ceeb hauv kev sib caisraumkev ua haujlwm ntawm renogram phynot pom ntawm CT kuj tsim kev txhawj xeeb txog kev pub dawb tom qab lub raum ua haujlwm rau cov kws kho mob thiab qhov muaj peev xwm ua rau muaj qhov tshwm sim tsis zoo hauv cov neeg mob uas tau txais kev tsis txaus siab, xaiv nephrectomy. Peb txoj kev tshawb fawb ntxiv granular cov ntaub ntawv piav qhia uasraumtau pub dawb thiab lawv lub raum ua haujlwm tom qab pub dawb nrog kev soj ntsuam ntev dua 37 lub hlis rau pab pawg no. Txawm tias tom qab pub dawbraumKev ua haujlwm tau tshwm sim zoo ib yam ntawm cov neeg pub dawb nrog qhov sib txawv tseem ceeb hauv kev sib cais hauv lub raum kev ua haujlwm pom ntawm renography tab sis tsis yog CT, tus lej no tsawg thiab tsis suav nrog kev tshuaj xyuas ntxiv ntawm lub peev xwm ntawm renography lossis CT los kwv yees tom qab pub dawb.raummuaj nuj nqi nyob rau hauv pab pawg neeg pub dawb, ib lo lus nug tseem ceeb rau kev tshawb fawb yav tom ntej. Tsis tas li ntawd, cais lub raum ua haujlwm tsis yog ib qho kev txiav txim siab ntawm lub raum xaiv rau kev pub dawb xav tias pub lawv siab dua, tsis yog qis dua, lub raum ua haujlwm.
Peb txoj kev tshawb fawb txawv ntawm lwm cov kev tshawb fawb uas pom qhov muaj zog kwv yees ntawm kev pub dawb tom qab eGFR [9–11]. Qhov laj thawj ntawm qhov sib txawv no tuaj yeem cuam tshuam rau peb lub sijhawm ua haujlwm ntev dua thaum cov kev tshawb fawb ua ntej tau tshuaj xyuas eGFR ntawm 6 txog 12 lub hlis nkaus xwb [9–11]. Txawm li cas los xij, ua raws li cov kev tshawb fawb yav dhau los, peb qhov kev soj ntsuam Bland-Altman tau lees paub tias feem ntau ntawm cov qhab nia sib txawv ntawm renography thiab txhua qhov ntawm 3 CT-raws li kev ntsuas nyob rau hauv 95 feem pua ntawm kev ntseeg siab ntawm qhov sib txawv, qhia txog kev pom zoo ntawm kev ntsuas CT-raws li yooj yim. thiab nuclear renography rau kev kwv yees ntawm kev sib caisraumua haujlwm zoo ib yam li cov kev tshawb fawb yav dhau los [9,10,14,17,20].
Lub zog ntawm peb txoj kev tshawb fawb muaj xws li cov ntaub ntawv muab los ntawm ib qho loj, tsis raug xaiv pub dawb pab pawg raws li txhua tus neeg sib tw pub dawb muaj cov ntaub ntawv pov thawj nuclear, thiab kev ua tau zoo ntawm kev sib koom ua ke (muaj 2 tus neeg soj ntsuam ywj pheej), uas ntau cov kev tshawb fawb tsis tau tshuaj xyuas rau kev txiav txim siab. kev tsim tawm [9–11,13,14,21]. Cov kev tshawb fawb uas ua ntej xaiv cov neeg pub dawb raws li cov txiaj ntsig ntawm cov duab tuaj yeem cuam tshuam rau qhov muaj feem yuav pom qhov sib txawv ntau dua 1 cm hauvraumntev thiab yog li ntawd discrepant splitraummuaj nuj nqi, whereas peb txoj kev tshawb fawb suav nrog tag nrho cov neeg pub dawb sib law liag txij thaum renography tau ua rau txhua tus neeg pub dawb hauv qhov kev pab cuam [14,17,22–24]. Cov kev txwv ntawm peb txoj kev tshawb fawb suav nrog nws qhov kev rov qab los, ib qho kev kawm tsim qauv, thiab tsis muaj kev ntsuas GFR ncaj qha. Lub raum Kab Mob: Txhim Kho Ntiaj Teb Cov Txheej Txheem Kev Ntsuas Kev Ntsuas thiab Kev Saib Xyuas Kev Ua NeejLub raumCov neeg pub dawb lees paub tias ob qho tib si ntsuas GFR thiab eGFR cuam tshuam nrog kev ua yuam kev [7]. Tsis tas li ntawd, KDIGO pom zoo tias tom qab pub dawb eGFR raug ntsuas los ntawm qib creatinine hauv cov ntshav vim tias lwm txoj hauv kev tsis muaj (cystatin C), ua tsis tau zoo (24- teev tso zis rau creatinine clearance), thiab kim (nuclear ntsuas) rau kev soj ntsuam niaj hnub [ 7]. Vim tias nws tsis paub meej tias ib txoj hauv kev ua tau zoo dua lwm qhov hauv kev kwv yees lub raum ua haujlwm ntev tom qab pub dawb, peb tau lees paub siv eGFR ua ntej thiab tom qab pub dawb los ntsuasraummuaj nuj nqi nyob rau hauv relation mus imaging. Muab hais tias eGFR nce los ntawm 1 ml / min / 1.73 m2 ib xyoos twg ntawm qhov nruab nrab mus txog 5 xyoo tom qab pub dawb, qhov tsis muaj qhov ntsuas ntsuas ntawm eGFR ntawm ntau lub sijhawm cov ntsiab lus kuj yog qhov txwv ntawm peb txoj kev kawm [25]. Peb tsis tau sau cov ntaub ntawv ntawm comorbidities tam sim no ua ntej lossis tom qab pub dawb thiab peb txoj kev tshawb fawb tsuas yog txwv rau cov neeg dawb feem ntau.
Mus rau pem hauv ntej nrog peb lub tsev nyobraumKev pabcuam pub dawb, peb yuav txuas ntxiv siv nuclear renography rau niaj hnub kwv yees ntawm kev faib lub raum ua haujlwm, vim tias muaj kev pheej hmoo ntawm kev ploj lawm qhov sib txawv tseem ceeb hauv kev faib lub raum los ntawm kev siv CT ib leeg. Rau cov neeg pub dawb me me uas muaj qhov chaw kho mob tseem ceeb ntawm lub raum kev ua haujlwm sib txawv ntawm renography-feem ntau ntawm cov neeg uas yuav tsis tau los ntawm CT ntsuas kev kwv yees ntawm kev faib lub raum ua haujlwm-tsis pom qhov txawv ntawm kev pub dawb raum ua haujlwm ntawm cov neeg pub dawb. lawv lub raum ua haujlwm siab dua lossis qis dua tab sis cov lej no tsawg thiab tsis tuaj yeem sawv cev ntawm cov pejxeem loj. Txawm hais tias kev siv CT-raws li kev ntsuas rau qhov kev kwv yees niaj hnub ntawm kev faib lub raum ua haujlwm yuav txo tau lub sijhawm, qhov nyuaj, thiab tus nqi cuam tshuam nrog kev soj ntsuam ntawm cov neeg nyob hauv lub raum pub dawb, peb cov ntaub ntawv tsis txhawb kev hloov peb txoj hauv kev siv CT-raws li kev ntsuas ib leeg. .
Cistanche siv kev kho mob raum
Txhawb nqa cov ntaub ntawv
S1 Cov ntaub ntawv. STROBE nqe lus.Daim ntawv teev cov khoom uas yuav tsum tau muab tso rau hauv cov ntawv ceeb toom ntawm kev soj ntsuam kev tshawb fawb nrog cov nplooj ntawv uas tsim nyog muab.
(PDF)
Kev lees paub
Peb ua tsaug rau Diana Dipelino, Tus NyobLub raumTus neeg ua haujlwm pub dawb, rau nws txoj kev pabcuam nrog kev sau cov ntaub ntawv.
Tus sau Kev koom tes
Conceptualization:Jean-Paul Salameh, Matthew DF McInnes, Ann Bugeja.
Cov ntaub ntawv kev kho mob:Kelly C. Harper, Natasha Akhlaq, Victoria Ivankovic, Mahdi H. Beydoun, Ann Bugeja.
Kev cai tsom xam:Kelly C. Harper, Jean-Paul Salameh.
Kev tshawb nrhiav:Wanzhen Zeng, Ann Bugeja.
Txoj kev:Matthew DF McInnes, Wanzhen Zeng.
Kev saib xyuas:Ann Bugeja.
Kev sau ntawv – tus thawj tsab ntawv:Kelly C. Harper, Ann Bugeja.
Kev sau ntawv – tshuaj xyuas & kho kom raug:Kelly C. Harper, Jean-Paul Salameh, Natasha Akhlaq, Matthew DF McInnes, Victoria Ivankovic, Mahdi H. Beydoun, Edward G. Clark, Wanzhen Zeng, Brian DM Blew, Kevin D. Burns, Manish M. Sood, Ann Bugeja.
1Department of Radiology, Tsev Kho Mob Ottawa, University of Ottawa, Ottawa, Ontario, Canada,
2Ottawa Tsev Kho Mob Tshawb Fawb Lub Tsev Kho Mob Kev Kab Mob Kab Mob, Ottawa, Ontario, Canada,
3Kws qhia ntawv ntawm Tshuaj, University of Ottawa, Ottawa, Ontario, Canada,
4Division of Nephrology, Department of Medicine, Kidney Research Center, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada,
5Division of Nuclear Medicine, Department of Medicine, University of Ottawa, Tsev Kho Mob Ottawa, Ottawa, Ontario, Canada,
6Division of Urology, Department of Surgery, Tsev Kho Mob Ottawa, University of Ottawa, Ottawa, Ontario, Canada
Cov ntaub ntawv
1. Ceka JM. Nyob pub dawb hloov. Clin Transpl. 1995: 363–77. PIB: 8794280
2. Eurotransplant International Foundation. Daim ntawv tshaj tawm txhua xyoo 2012 Eurotransplant International Foundation [Internet]. 2013. [cited August 21, 2020].
3. Canadian Institute for Health Information. Kev Tshawb Fawb Txhua Xyoo ntawm Kev Hloov Lub Cev Hauv Tebchaws Canada. Dialysis, Transplantation and Donation, 2008 to 2017 Canadian Institute for Health Information. 2018. [mus txog Lub Plaub Hlis 21, 2021].
4. Daim Ntawv Qhia Txog Kev Pub Dawb thiab Kev Hloov Pauv 2019 [Internet]. Ntiaj teb no Database ntawm pub dawb thiab hloov pauv. Lub Koom Haum Ntiaj Teb Kev Noj Qab Haus Huv - Organizacio'n Nacional de Trasplantes; 2019 [mus txog Lub Plaub Hlis 23, 2021].
5. Al Ammar F, Yu Y, Ferzola A, Motter JD, Massie AB, Yu S, et al. Thawj qhov nce hauv kev ua neej nyobraumpub dawb hauv Tebchaws Meskas hauv 15 xyoos. American Journal of Transplantation. 2020; 20(12):3590-8.
6. Habbous S, Woo J, Lam NN, Lentine KL, Cooper M, Reich M, et al. Qhov Ua Tau Zoo ntawm Kev Ntsuam Xyuas Cov Neeg Sib Tw rau Kev Noj Qab Haus Huv Rau Kev Noj Qab Haus Huv: Kev Ntsuam Xyuas Scope. Hloov Direct. 2018; 4 (10): e394. PIB: 30498771
7. Lentine KL, Kasiske BL, Levey AS, Adams PL, Albert J, Bakr MA, et al. KDIGO Clinical Practice Guide the line on the Evaluation and Care of LivingLub raumCov neeg pub dawb. Kev hloov pauv. 2017; 101 (8S Suppl 1): S1–S109. PIB: 28742762
8. Richardson R, Connelly M, Dipchand C, Garg AX, Ghanekar A, Houde I, et al.Lub raumPaired Donation Protocol rau Cov Neeg Pab Koom Tes 2014. Kev Hloov Pauv. 2015; 99 (10 Suppl 1): S1–S88. PIB: 26425842
9. Barbas AS, Li Y, Zair M, Van JA, Famure O, Dib MJ, et al. CT volumetry yog qhov zoo tshaj plaws rau nuclear renography rau kev kwv yees ntawm lub raum seem hauv cov neeg pub dawb. Clin Hloov. 2016; 30(9):1028–35. PIB: 27396944
10. Hall IE, Shaaban A, Wei G, Sikora MB, Bourija H, Beddhu S, et al. Baseline nyob- pubraumntim thiab kev ua haujlwm cuam tshuam nrog 1- xyoo tom qab nephrectomy raum ua haujlwm. Clin Hloov. 2019; 33 (3): e13485. PIB: 30689244
11. Halleck F, Diederichs G, Koehlitz T, Slowinski T, Engelken F, Liefeldt L, et al. Volume matters: CT-raws li lub raum cortex volume ntsuas nyob rau hauv kev ntsuam xyuas ntawm nyobraumpub dawb. Transpl Int. 2013; 26 (12): 1208–16. PIB: 24118327
12. Herts BR, Sharma N, Lieber M, Freire M, Goldfarb DA, Poggio ED. Kwv yees glomerular filtration rate nyob rau hauvraumCov neeg pub dawb: tus qauv tsim nrog lub raum ntim ntsuas los ntawm tus neeg pub dawb CT scans. Xov tooj cua. 2009; 252(1):109–16 : kuv.
13. Shi W, Liang X, Wu N, Zhang H, Yuan X, Tan Y. Kev ntsuam xyuas ntawm kev sib cais lub raum ua haujlwm siv kev sib xyaw ua ke ntawm qhov sib txawv-Enhanced CT thiab Serum Creatinine Values rau Glomerular Filtration Rate Estimation. AJR Am J Roentgenol. 2020; 215(1):142–7 : kuv.
14. Wahba R, Franke M, Hellmich M, Kleinert R, Cingoz T, Schmidt MC, et al. Xam Tomography Volumetry hauv Preoperative LivingLub raumKev ntsuam xyuas pub dawb rau kev kwv yees ntawm kev sib cais lub raum ua haujlwm. Kev hloov pauv. 2016; 100(6):1270–7. PIB: 26356175
15. Graham JM, Courtney AE. Kev lees txais tus Qauv Kev Ntsuas Ib Hnub pub dawb hauv kev ua neej nyobLub raumKev Pab Txhawb Kev Hloov Pauv: Ib Qhov Kev Txhim Kho Kom Zoo. Am J Raum Dis. 2018; 71(2):209–15 : kuv. PIB: 29150247
16. von Elm E, Altman DG, Egger M, et al. Kev Txhim Kho Kev Tshaj Tawm Txog Kev Tshawb Fawb Kev Tshawb Fawb Hauv Kab Mob Kab Mob (STROBE) nqe lus: cov lus qhia rau kev tshaj tawm cov kev tshawb fawb soj ntsuam. Kab mob sib kis. 2007; 18 (6): 800–804 : kuv. PIB: 18049194
17. Soga S, Britz-Cunningham S, Kumamaru KK, Malek SK, Tullius SG, Rybicki FJ. Kev sib piv kev tshawb fawb ntawm kev suav tomography-raws li kev kwv yees ntawm kev sib cais lub raum ua haujlwm rau cov neeg muaj peev xwm lub raum: hloov ellipsoid txoj kev thiab lwm txoj hauv kev CT. J Comput Assist Tomogr. 2012; 36 (3): 323–9. PIB: 22592618
18. NPE MM. Statistics ces kaum: Phau ntawv qhia txog kev siv cov coefficient sib raug zoo hauv kev tshawb fawb kho mob.Malawi Med J. 2012; 24(3):69–71 : kuv. PIB: 23638278
19. Koo TK, Li MY. Ib Txoj Kev Qhia Txog Kev Xaiv thiab Tshaj Tawm Txog Kev Sib Raug Zoo ntawm Intraclass Coefficients rau Kev Tshawb Fawb Kev Ntseeg. J Chiropr Med. 2016; 15(2):155–63 : kuv. PIB: 27330520
20. Patankar K, Low RS, Blakeway D, Ferrari P. Kev sib piv ntawm lub computer tomographic volumetry piv rau nuclear split lub raum muaj nuj nqi los txiav txim qhov seem ntawm lub raum ua haujlwm tom qab nyob.raumpub dawb. Acta Radiol. 2014; 55(6):753–60. PIB: 24014687
