Quantitative evaluation of upper urinary tract pump function in pigs with acute unilateral lower ureteral obstruction by 640-slice dynamic volume CT

BMC Urol. 2021 Sep 2;21(1):118. doi: 10.1186/s12894-021-00887-4.

Abstract

Background: It is a challenging problem to differentiate obstructive hydronephrosis from noninvasive evaluation of renal pelvis and ureteral motility in patients. The purpose of this study was to explore the value of 640-slice dynamic volume CT (DVCT) in the quantitative measurement of upper urinary tract (UUT) pump function after acute unilateral lower ureteral obstruction in pigs.

Methods: In this study, a perfusion pig model was constructed by constant pressure perfusion testing of the renal pelvis and left nephrostomy. The perfusion and pressure measuring devices were connected to create a state of no obstruction and acute obstruction of the lower part of the left ureter. After successful modelling, continuous dynamic volume scanning of the bilateral renal excretion phase was performed with 640-slice DVCT, and pump functions of the renal pelvis and part of the upper ureter were calculated and analysed. No obstruction or acute obstruction of the lower part of the left ureter was observed. Pump functions of the renal pelvis and part of the upper ureter were determined.

Results: The results showed that after LUUT fistulostomy, the time difference between the average UUT volume and positive volume value increased gradually, and the calculated flow velocity decreased, which was significantly different from that of the RUUT. The volume difference of the LUUT increased significantly in mild obstruction. In the bilateral control, the volume change rate of the LUUT increased with mild obstruction and decreased with severe obstruction, and there was a significant difference between the left and right sides.

Conclusion: The continuous dynamic volume scan and measurement of 640-slice DVCT can obtain five pump function datasets of UUT in pigs with acute lower ureteral obstruction.

Keywords: Dynamic volumetric CT; Pump function; Renal pelvis constant pressure perfusion test; Upper urinary tract urodynamics; Urethral obstruction.

MeSH terms

  • Animals
  • Cone-Beam Computed Tomography*
  • Hydronephrosis / diagnostic imaging
  • Hydronephrosis / physiopathology
  • Swine
  • Ureteral Obstruction / diagnostic imaging*
  • Ureteral Obstruction / physiopathology*
  • Urinary Tract / diagnostic imaging*
  • Urinary Tract / physiopathology*
  • Urodynamics