A new method of evaluation of split renal function based on contrast-enhanced multislice spiral computed tomography


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Abstract

Introduction. Traditionally, evaluation of the split renal function is performed using nephroscintigraphy. However, as shown in several studies, there might be quite significant inaccuracy in the interpretation ofdynamic nephroscintigraphy results. But due to the lack of alternative methods for evaluation of split renal function, nephroscintigraphy remains the method of choice. Aim. To investigate the feasibility of digital analysis of contrast-enhanced MSCT imaging for evaluation of the split renal function. Materials and methods. This is a prospective study conducted at the R.M. Fronshteyn Clinic of Urology from November 2015 to February 2017. The study comprised 31 patients with urolithiasis (n=7), hydronephrosis (n=9), kidney cancer (n=14) and urinary bladder tumor (n=1). During the preoperative period, the patients underwent contrast-enhanced MSCT, 3D-reconstruction, and digital analysis. The obtained data were compared with the results of dynamic nephroscintigraphy. Results Contrast-enhanced MSCT findings were not inferior to data obtained with dynamic nephroscintigraphy regarding information content (p<0.004). Conclusions. The new method of digital processing of three-dimensional contrast-enhanced MSCT allows for concomitant assessment of both the anatomical features of the kidney and renal function that may help to improve the accuracy of surgical planning to choose the optimal extension of the intervention.

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About the authors

Yu. G Alyaev

R.M. Fronshteyn Clinic of Urology, I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

Corr.-Member of the RAS, Dr.Med.Sci., Prof., Head of the Department of Urology

N. K Dzeranov

Research Institute for Uronephrology and Human Reproductive Health, I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

Dr.Med.Sci., Prof., Honored Physician of Russia

S. B Khokhlachev

Research Institute for Uronephrology and Human Reproductive Health, I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

Ph.D. (phys/math.) 3D-modeling Engineer at the Research Institute for Uronephrology and Human Reproductive Health

V. V Borisov

Research Institute for Uronephrology and Human Reproductive Health, I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University); I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

Dr.Med.Sci., Prof. at the Department of Nephrology and Hemodialysis, Institute of Vocational Education

D. N Fiev

R.M. Fronshteyn Clinic of Urology, I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University); Research Institute for Uronephrology and Human Reproductive Health, I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

Email: fiev@mail.ru
Dr.Med.Sci., Leading Researcher at the Research Institute for Uronephrology and Human Reproductive Health, Urologist at the R.M. Fronshteyn Clinic of Urology

Yu. L Demidko

R.M. Fronshteyn Clinic of Urology, I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

Email: demidko1@mail.ru
Urologist at the R.M. Fronshteyn Clinic of Urology

A. V Proskura

R.M. Fronshteyn Clinic of Urology, I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

Email: proskura777@yandex.ru
Ph.D. Student at the Department of Urology of Sechenov University, Urologist at the Department of Urologic Oncology

M. V Yurova

I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

Email: yurova.m.vl@gmail.com
Sixth Year Student

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