Evaluation of hydronephrotic kidney parenchymal density by non-contrast multislice computed tomography

Abstract

It is well known that a prolonged ureteral obstruction leads to function loss of the congested kidney. Determining whether kidney stones cause any obstruction by non-contrast multislice CT is crucial for deciding about the timing of treatment. In our study we evaluated by Non-Contrast Multislice Computed Tomography (NCMSCT) detectable reliable changes of the density of the renal parenchyma in rats with artificial hydronephrosis. We made total or partial obstruction to left ureters of Spraque-Dawley rats, and applied sham operation to control groups. Using NCMSCT we measured the renal average parenchyma densities in the first, third and thirteenth days of operation. There was no significant difference between the parenchyma density of partial obstructed group and control group. However the parenchyma density in totally obsructed kidneys has significantly decreased compared to the contralateral kidneys and control group. In this group the duration of the obstruction correlated with significantly decreased parenchyma density. The average density values of the upper, middle and lower renal segments were similar. We assume that our results can be useful in the evaluation of the consequences of the ureteral obstruction. The decrease of the parenchyma density evaluated in NCMSCT could be an important indicator of the renal parenchymal damages. Hidronefrotik bobrek parankim dansitesinin kontrastsiz cok kesitli bilgisayarli tomografi kullanilarak degerlendirilmesi Uzun suren ureteral obstruksiyonun bobrek fonksiyon kaybina neden oldugu iyi bilinmektedir. Uriner sistem tasina bagli herhangi bir obstruksiyonun kontrastsiz cok kesitli bilgisayarli tomografi (KCKBT) ile belirlenmesi tedavi zamanlamasi hakkinda karar vermek acisindan cok onemlidir. Calismamizda deneysel hidronefroz olusturulan ratlarda renal parankim dansitesinde meydana gelen degisiklikler KCKBT ile degerlendirildi. Bu calismada sol ureterlerinde total veya parsiyel obstruksiyon olusturulmus Spraque-Dawley ratlarin bobrek parankim dansiteleri deneyin 1.,3. ve 30. gunlerinde KCKBT ile degerlendirilerek, sham ve kontrol grubu ratlarin bobrek parankim dansiteleri ile karsilastirildi. Parsiyel ureteral obstruksiyon olusturulmus ratlarin bobrek parankim dansiteleri ile kontrol grubunun bobrek parankim dansiteleri arasinda anlamli bir fark olmadigi saptandi. Bununla birlikte total ureteral obstruksiyon olusturulmus ratlarin bobrek parankim dansitelerinin karsi taraf bobrekleri ve kontrol grubu ile karsilastirildiginda anlamli olarak azaldigi saptandi. Elde edilen bu bulgularin insanlarda ureter obstruksiyonun sonuclarinin degerlendirilmesinde yararli olabilecegini dusunmekteyiz. KCKBT degerlendirilmesinde renal parankim dansitesinin azalmasi renal parankimal hasarin bir gostergesi olabilir. J. Exp. Clin. Med., 2012; 29:215-220