Application of Multi-Slice CT Perfusion Scan in the Evaluation of Early Recovery of Renal Function After Releasing of Unilateral Ureteral Obstruction

Objective:To evaluate the predictability of multi-slice CT (MSCT) perfusion scan in the restorability of renal function in rabbit model with partial unilateral (right) ureteric obstruction and to investigate the changes of MSCT perfusion parameters during the recovery course of renal function. Methods: Hydronephrotic rabbits were randomly assigned into control, 2-, 4-, and 8-week obstruction groups. BUN and Cr levels of all the obstruction groups before obstruction and 4 weeks after the obstruction were measured and compared with that of the control respectively. MSCT perfusion scan, color Doppler flow imaging, and SPECT examinations were performed and renal specimens were observed with HE staining. Results: Glomerular filtration rates (GFR) in the three obstruction groups were lower than that in control group, and no significant change was found among the obstruction groups in total GFR after the obstruction was released. There was a slight recovery in right renal GFR only in 2-week obstruction group after obstruction was released. The end diastolic velocity (EDV) of intrarenal arteries in 4- and 8-week obstruction groups, instead of 2-week obstruction group, after reperfusion was significantly lower than that in control group. Blood flow (BF) and blood volume (BV) values of renal cortex and medulla in 2-week group restored significantly even to the level of control group after reperfusion, but changed little in 4- and 8-week groups. There was a positive correlation between duration of obstruction and degree of pathologic changes. Conclusion: MSCT perfusion scan is a useful method to evaluating the recovery of renal function of obstructive hydronephrosis, especially combined with color Doppler flow imaging.