medvisМедицинская визуализацияMedical Visualization1607-07632408-9516RDS-Media Ltd.10.24835/1607-0763-1220medvis-1220Research ArticleБРЮШНАЯ ПОЛОСТЬ И ЗАБРЮШИННОЕ ПРОСТРАНСТВОABDOMEN AND RETROPERITONEALПерфузионная компьютерная томография в диагностике заболеваний почек (обзор литературы)Application of perfusion computed tomography in renal diseases (review of literature)https://orcid.org/0000-0002-9474-1074ЛомоносоваЕ. В.LomonosovaE. V.

Ломоносова Елена Владимировна – врач-рентгенолог отделения компьютерной и магнитно-резонансной томографии

125284 Москва, 2-й Боткинский проезд, 3

Elena V. Lomonosova – radiologist, Department of computed tomography and magnetic resonance imaging

3, 2nd Botkinskiy pr., Moscow 125284

elena_kryaneva@mail.ruhttps://orcid.org/0000-0002-4030-3212ГольбицА. Б.GolbitsA. B.

Гольбиц Александра Борисовна – врач-рентгенолог отделения компьютерной и магнитно-резонансной томографии

125284 Москва, 2-й Боткинский проезд, 3

Aleksandra B. Golbits – radiologist, Department of computed tomography and magnetic resonance imaging

3, 2nd Botkinskiy pr., Moscow 125284

a_golbits@mail.ruhttps://orcid.org/0000-0001-8378-4338РубцоваН. А.RubtsovaN. A.

Рубцова Наталья Алефтиновна – доктор медицинских наук, руководитель отдела лучевой диагностики

125284 Москва, 2-й Боткинский проезд, 3

Natalia A. Rubtsova – Doct. of Sci. (Med.), Head of Radiology Department

3, 2nd Botkinskiy pr., Moscow 125284

rna17@yandex.ruhttps://orcid.org/0000-0002-3398-4128АлексеевБ. Я.AlekseevB. Ya.

Алексеев Борис Яковлевич – доктор медицинских. наук, профессор, заместитель генерального директора по научной работе ФГБУ “НМИЦ радиологии” Минздрава России

125284 Москва, 2-й Боткинский проезд, 3; 125080 Москва, Волоколамское шоссе, д. 11

Boris Ya. Alekseev – Doct. of Sci. (Med.), Professor, Deputy of General director of scientific affairs “National Medical Research Center of Radiology” o

3, 2nd Botkinskiy pr., Moscow 125284; 11, Volokolamskoye shosse, Moscow 125080

byalekseev@mail.ruhttps://orcid.org/0000-0001-8784-8415КапринА. Д.KaprinA. D.

Каприн Андрей Дмитриевич – академик РАН, член-корр. РАО, доктор медицинских наук, профессор, генеральный директор ФГБУ “НМИЦ радиологии” Минздрава России; заведующий кафедрой урологии и оперативной нефрологии с курсом онкоурологии медицинского факультета, медицинского института ФГАОУ ВО “Российский университет дружбы народов”

125284 Москва, 2-й Боткинский проезд, 3; 117198 Москва, ул. Миклухо-Маклая, 6

Andrey D. Kaprin – Full Member of the Russian Academy of Sciences, Corresponding Member of Russian Academy of Education, Doct. of Sci. (Med.), Professor, General Director; Head of Department of urology and surgical nephrology with a course of oncourology at the medical faculty of medical institute

3, 2nd Botkinskiy pr., Moscow 125284; 6, Miklukho-Maklay str., Moscow 117198

kaprin@mail.ruМосковский научно-исследовательский онкологический институт им. П.А. Герцена – филиал ФГБУ “НМИЦ радиологии” Минздрава РоссииРоссияMoscow Research Oncological Institute named after P.A. Herzen – branch of “National Medical Research Center of Radiology” Ministry of Healthcare of RussiaRussian FederationМосковский научно-исследовательский онкологический институт им. П.А. Герцена – филиал ФГБУ “НМИЦ радиологии” Минздрава России; ФГБОУ ВО “Российский биотехнологический университет”РоссияMoscow Research Oncological Institute named after P.A. Herzen – branch of “National Medical Research Center of Radiology” Ministry of Healthcare of Russia; Russian Biotechnological UniversityRussian FederationМосковский научно-исследовательский онкологический институт им. П.А. Герцена – филиал ФГБУ “НМИЦ радиологии” Минздрава России; ФГАОУ ВО “Российский университет дружбы народов” Минобрнауки РоссииРоссияMoscow Research Oncological Institute named after P.A. Herzen – branch of “National Medical Research Center of Radiology” Ministry of Healthcare of Russia; Peoples' Friendship University of RussiaRussian Federation2023060420232728598Copyright © Ломоносова Е.В., Гольбиц А.Б., Рубцова Н.А., Алексеев Б.Я., Каприн А.Д., 20232023Ломоносова Е.В., Гольбиц А.Б., Рубцова Н.А., Алексеев Б.Я., Каприн А.Д.Lomonosova E.V., Golbits A.B., Rubtsova N.A., Alekseev B.Y., Kaprin A.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medvis.rdsmedia.ru/jour/article/view/1220Цель исследования

Цель исследования: провести анализ литературных данных по использованию КТ-перфузии при заболеваниях почек и оценить дальнейшие перспективы применения методики в клинической практике.

Материал и методы

Материал и методы. В электронных базах данных (PubMed, E-library, Web of Science, Google Scholar) был проведен поиск опубликованных исследований, оценивающих возможности применения КТ-перфузии при заболеваниях почек как неопластического, так и неопухолевого характера. В статье проанализированы результаты 40 наиболее релевантных работ российских и зарубежных исследователей, посвященных этой тематике.

Результаты

Результаты. Согласно анализу полученных данных, перфузионная КТ является эффективным диагностическим инструментом в онкологии: методика позволяет неинвазивно оценить характер новообразования, в том числе дифференцировать доброкачественные узлы (ангиомиолипому с низким содержанием жира и онкоцитому) от рака почки, установить гистологический вариант почечно-клеточного рака и степень злокачественности опухоли по Fuhrman, охарактеризовать эффективность аблативных методик и системного лечения рака почки. Базируясь на корреляции данных КТ-перфузии почек и результатов различных методов определения функции органа, доказана возможность применения перфузионной КТ в качестве одного из прогностических факторов для определения тактики лечения больных с обструктивными уропатиями, аортомезентериальной компрессией, а также показан потенциал использования методики в трансплантологии как у пациентов после проведенной операции, так и при обследовании доноров.

Заключение

Заключение. Несмотря на то что роль КТ-перфузии почек в различных областях урологии и нефрологии достаточно изучена, некоторые важные аспекты вероятного применения этой методики остаются недооцененными. С учетом высоких показателей заболеваемости и значимого процента локализованных форм опухолей изучение роли КТ-перфузии в планировании и оценке результатов органосохраняющего лечения рака почки может открыть новые перспективы в оптимизации хирургической тактики.

Purpose

Purpose. To analyze the literature data on the use of CT perfusion in kidney diseases and to assess the future prospects of using the technique in clinical practice.

Materials and methods

Materials and methods. In electronic databases (PubMed, E-library, Web of Science, Google Scholar), a search was conducted for published studies evaluating the possibilities of using CT perfusion in both neoplastic and non-neoplastic kidney diseases. The article analyzes the results of 40 most relevant works of Russian and foreign researchers devoted to this topic.

Results

Results. According to the analysis of the data obtained, perfusion CT is an effective diagnostic tool in oncology: the technique allows noninvasively assessing the nature of the tumour, including differentiating benign nodes (fat-poor angiomyolipoma and oncocytoma) from renal cell carcinoma; to establish the histological variant of renal cell carcinoma and Fuhrman grade, to characterize the effectiveness of ablative techniques and systemic treatment of renal cell carcinoma. Based on the correlation of CT kidney perfusion data and the results of various methods for determining organ function, the possibility of using perfusion CT as one of the prognostic factors for determining the tactics of treatment of patients with obstructive uropathies, aortomesenteric compression, and also shows the potential of using the technique in transplantology both in patients after surgery and during the examination of donors.

Conclusions

Conclusions. Despite the fact that the role of CT kidney perfusion in various fields of urology and nephrology has been sufficiently studied, some important aspects of the likely application of this technique remain underestimated. Taking into account the high incidence rates and a significant percentage of localized forms of tumors, the study of the role of CT perfusion in planning and evaluating the results of nephron-sparing treatment of renal cell carcinoma may open up new prospects in optimizing surgical tactics.

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The authors declare that there are no conflicts of interest present.