Objective: To explore the feasibility of multi-slice spiral computed tomography (CT) with a lower dose as one-off examination for the preoperative morphology evaluation and the quantification of unilateral renal glomerular filtration rate of living renal donors.
Methods: A total of 36 living renal donors at our hospital from May 2008 to June 2009 were examined by 64-slice spiral CT and single photon emission computed tomography (SPECT). Living renal donors were examined with a plain scan and three-phase enhancement CT scan. Also there were two inserted dynamic scans, one after the injection of contrast agent and the other between cortex and parenchymal phases. Image reconstructions were performed to observe renal parenchyma, renal vessels and collecting system. Comparisons were made with intra-operative findings. And the known Patlak equation was used simultaneously. The glomerular filtration rate (GFR) in a single kidney was calculated on CT and SPECT respectively. The GFRs of two groups were analyzed to investigate the Pearson correlation and simple linear regression between them.
Results: Twenty of 36 renal living donor kidneys underwent the operation, variations of morphology detected by CT were all corresponded with the operation. The GFR values estimated from CT were (42.4 ± 8.9) ml/min (left) and 43.2 ± 8.4) ml/min (right). While GFR of SPECT 47.4 ± 9.3) ml/min (left) and 48.2 ± 8.5) ml/min (right). Linear trend was found between the GFRs of CT and SPECT. Pearson's product-moment correlation coefficient r = 0.753 (left) (P < 0.01), r = 0.709 (right) (P < 0.01). These values indicated that the GFR from CT was positively correlated with the GFR from SPECT.
Conclusion: During the preoperative evaluation, multi-slice spiral CT may provide both anatomic information and the GFR of living renal donors.