Perfusion computed tomography could be a new tool for single-session imaging of ureteric obstructive pathology: an experimental study in rats.
OBJECTIVE
Perfusion imaging redefines computed tomography (CT) as a technique that can now depict vascular physiology in addition to detailed anatomy. The major clinical applications of perfusion CT are in acute stroke and oncology. Currently, there are very limited data on the application of perfusion CT in urology. The aim of the present study is to investigate the potential value of perfusion CT in anatomic and functional evaluation of obstruction in a single session on experimental hydronephrosis model in rats. Thus, we evaluate the perfusion CT in a new clinical application.


METHODS
Twenty-eight rats were randomly allocated into 4 groups each consisting of 7 rats. At the third week of experimental intervention, postoperative renogram curves and perfusion parameters of the right kidneys' cortex and pelvis were assessed by CT. The right ureter was sutured as proximal complete obstruction in group 1, as distal complete obstruction in group 2, and as proximal partial obstruction in group 3. Group 4 served as the sham control group. Computed tomography was performed with single-slice tomography. Dynamic examination was performed with the help of perfusion software through contrast-enhanced tomography examination.


RESULTS
In all study groups, the aorta time/density curves showed a rapid increase after a rapid decrease, and the duration to reach peak concentration in the normal kidney cortex was observed to be later than the aorta as expected. In groups 1, 2, and 3, the duration to reach peak concentration lengthened and the peak concentration values decreased. The time/density curves gradually increased as a result of the accumulation of the contrast agent in the pelvis, and a peak was observed at the end of the procedure in all study groups. In groups 1, 2, and 3, a statistically significant decrease (P = .01, P = .01, and P = .01, respectively) was observed in the peak concentration values of the contrast agent in comparison to group 4. The flow and blood volume values gradually decreased as the grade of the obstruction increased and the localization of the obstruction or grade of obstruction moved closer to the kidney.


CONCLUSIONS
In conclusion, perfusion CT technique, performed in a single session, is a useful method for anatomic visualization, together with functional evaluation, in the diagnosis of ureteric obstructive pathology of experimental hydronephrosis model.
Medical Faculty, Department of Pediatric Surgery, Celal Bayar University, Manisa 45010, Turkey. omeryilmaz71@gmail.com
Omer
O
Yilmaz
Gulgun Y
GY
Ovali
Abdulkadir
A
Genc
Serdar
S
Tarhan
Teoman
T
Ozcan
Ozum
O
Tuncyurek
Yuksel
Y
Pabuscu
Can
C
Taneli
D000818:Animals; D003287:Contrast Media; D004195:Disease Models, Animal; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000473:pathology; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional; D007668:Kidney / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology*; D007672:Kidney Cortex / Q000000981:diagnostic imaging; D007682:Kidney Pelvis / Q000000981:diagnostic imaging; D055420:Perfusion Imaging / Q000379:methods*; D011866:Radioisotope Renography / Q000379:methods; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D012079:Renal Circulation / Q000502:physiology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014513:Ureter / Q000000981:diagnostic imaging / Q000473:pathology; D014517:Ureteral Obstruction / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology*
D003287:Contrast Media