Abstract
BackgroundIt 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.MethodsIn 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.ResultsThe 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.ConclusionThe 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.
Highlights
It is a challenging problem to differentiate obstructive hydronephrosis from noninvasive evaluation of renal pelvis and ureteral motility in patients
The clinical quantitative evaluation of upper urinary tract urodynamics still depends on classical upper urinary tract urodynamic tests, that is, the renal pelvis constant pressure perfusion test and renal pelvis constant flow perfusion pressure test (Whitaker test) [6]
A pig model of renal pelvis constant pressure perfusion (CPP) was established, and the upper urinary tract under different conditions of lower ureteral obstruction was scanned by a 640-slice dynamic volume CT scanning technique
Summary
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. Because the above two tests are invasive tests, they are only used in patients with nephrostomy [7] In this experiment, a pig model of renal pelvis constant pressure perfusion (CPP) was established, and the upper urinary tract under different conditions of lower ureteral obstruction was scanned by a 640-slice dynamic volume CT scanning technique. Data were calculated and analysed to obtain the change rule of pump function of the upper urinary tract under different obstruction conditions to determine an imaging method for the noninvasive quantitative evaluation of upper urinary tract urodynamics instead of CPP. It is expected that this approach can replace the renal pelvis CPP test as an effective method for noninvasive quantitative imaging evaluation of UUT urodynamics
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