PERSISTENT CT-NEPHROGRAM - SIGNIFICANCE IN THE DIAGNOSIS OF CONTRAST NEPHROPATHY
PERSISTENT CT-NEPHROGRAM - SIGNIFICANCE IN THE DIAGNOSIS OF CONTRAST NEPHROPATHY
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DOI：
10.1148/radiology.172.1.2740495
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发表时间：
1989-07-01
期刊：
影响因子：
19.7
通讯作者：
OLSON, MC
中科院分区：
文献类型：
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作者：
LOVE, L;LIND, JA;OLSON, MC
该前瞻性研究涉及50名没有已知肾脏肿块或既往肾脏手术的患者，这些患者接受了血管内造影剂进行各种放射学检查，随后在22-26小时后接受了肾脏非增强计算机断层扫描（CT）。在42例患者中，皮质读数不超过50 HU，皮质髓质衰减差异（CMAD）不超过10 HU。在7名患者（中间组）中，有持续的皮质增强（平均衰减，58.3-84.8 HU; CMAD，10.3-40.3 HU），但血面积氮或血清肌酐水平没有显著升高。1例患者患有造影剂肾病，24小时CT扫描显示平均皮质衰减为141.6 HU，平均CMAD为85.8 HU。作者还发现了另外两例造影剂肾病，其24小时CT扫描的平均皮质衰减分别为162和209 HU。其中1例患者在前瞻性研究中属于中间组。在24小时造影后扫描中，55-110 HU的皮质衰减可能有助于识别一组亚临床肾损害患者，这些患者在随后暴露于造影剂时具有肾病的高风险，而皮质衰减超过140 HU似乎是造影剂肾病的早期指标。
The prospective study involved 50 patients without known renal masses or previous renal surgery who received intravascular contrast medium for various radiologic procedures and subsequently underwent unenhanced computed tomography (CT) of the kidneys 22-26 hours later. In 42 patients, cortical readings did not exceed 50 HU and corticomedullary attenuation differences (CMADs) did not exceed 10 HU. In seven patients (intermediate group), there was persistent cortical enhancement (mean attenuation, 58.3-84.8 HU; CMAD, 10.3-40.3 HU), but there was no significant rise in levels of blood area nitrogen or serum creatinine. A single patient had contrast nephropathy and exhibited a mean cortical attenuation of 141.6 HU and a mean CMAD of 85.8 HU on the 24-hour CT scan. The authors have seen two additional cases of contrast nephropathy presaged by mean cortical attenuations of 162 and 209 HU on the 24-hour CT scan. One of these patients had been in the intermediate group in the prospective study. A cortical attenuation of 55-110 HU on a 24-hour postcontrast scan may help identify a group of patients with subclinical renal impairment who are at high risk of nephropathy on subsequent exposure to contrast medium, while cortical attenuations in excess of 140 HU seem to be an early indicator of contrast nephropathy.