Application of perfusion computed tomography in renal diseases (review of literature)

Abstract

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. 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. 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. 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.