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目的探讨三维超声测量肾实质容积比率(RPVR)间接评估小儿肾积水患侧肾脏功能的临床价值。方法 25例单侧肾积水患儿,其中男性21例,女性4例;年龄3个月~14岁,平均年龄4.4岁。进行三维超声检查测定患侧肾脏RPVR,进行肾核素动态显像测定肾小球滤过率(GFR),并将两者作相关性分析。结果患侧RPVR明显低于健侧(P<0.01),积水程度越重,RPVR越低;患侧RPVR与GFR呈正相关(r=0.617,P=0.001),当RPVR≤0.55时,患侧肾GFR下降至健侧肾的50%及以下,接受者操作特征(ROC)曲线下面积为0.87,诊断灵敏度为97.7%,特异度为62.8%。结论通过三维超声测量RPVR间接评估肾积水小儿患侧肾脏功能是一种可行的方法,RPVR值越低,GFR越低,肾脏功能损害越重,有较高的诊断灵敏度,可作为一项初步筛查小儿肾积水患侧肾脏功能的检查方法。
Objective To investigate the clinical value of indirect three-dimensional (RPVR) measurement of renal volume in children with hydronephrosis. Methods Twenty-five children with unilateral hydronephrosis, including 21 males and 4 females, aged from 3 months to 14 years with a mean age of 4.4 years. The three-dimensional ultrasonography was used to measure the RPVR in the ipsilateral kidney, and the glomerular filtration rate (GFR) was measured by dynamic imaging of the radionuclide. The correlation between them was analyzed. Results The RPVR in the affected side was significantly lower than that in the healthy side (P <0.01), and the more severe water was, the lower the RPVR was. The RPVR in the affected side was positively correlated with GFR (r = 0.617, P = 0.001) Kidney GFR decreased to 50% or less in the contralateral kidney. The area under the receiver operating characteristic (ROC) curve was 0.87 with a diagnostic sensitivity of 97.7% and a specificity of 62.8%. CONCLUSION: It is a feasible method to indirectly evaluate renal function in children with hydronephrosis by measuring RPVR by three-dimensional ultrasonography. The lower the value of RPVR, the lower the GFR, the heavier the renal dysfunction and the higher diagnostic sensitivity, which can be used as a preliminary Screening of children with hydronephrosis ipsilateral renal function tests.