OBJECTIVE: To summarize scientific evidence on image tests for pre-donation and/or post-nephrectomy renal function evaluation.
METHODS: This review followed the guidelines set by the European Association of Urology and adhered to PRISMA 2020 recommendations. The protocol was registered in PROSPERO on 10th December 2022 (ID: CRD42022379273).
RESULTS: Twenty-one studies met the inclusion criteria after thorough screening and eligibility assessment. According to QUADAS-2, patient selection and flow/timing domains showed a predominant low risk of bias. The correlation between split renal function (SRF) using CT and scintigraphy varied from weak (r = 0.21) to remarkably strong (r = 0.949). Bland-Altman agreement demonstrated moderate to excellent results, with mean differences ranging from -0.06% to 1.76%. The correlation between split renal volume (CT) and estimated glomerular filtration rate (eGFR) at 6 months or 1 year after nephrectomy showed a moderate correlation, with coefficients ranging from 0.708 to 0.83. The correlation between SRF (MRI) and renal scintigraphy reported a moderate correlation, with correlation coefficients of 0.58 and 0.84. MRI and scintigraphy displayed a good agreement, with a 66% agreement observed and mean differences of ± 0.3%.
CONCLUSIONS: Despite study heterogeneity, MRI or CT-based renal volumetry appears promising compared to scintigraphy, with favorable correlations and agreement.
目的:总结捐献前和/或肾切除术后肾功能评估的影像学检查的科学依据。
方法:本综述遵循了欧洲泌尿外科协会制定的指南,并遵循了PRISMA2020的建议。该协议于2022年12月10日在PROSPERO注册(ID:CRD42022379273)。
结果:21项研究在经过全面筛选和资格评估后符合纳入标准。根据QUADAS-2,患者选择和流/定时域显示出主要的低偏倚风险。使用CT和闪烁显像术的分裂肾功能(SRF)之间的相关性从弱(r=0.21)到明显强(r=0.949)。Bland-Altman协议显示出中等到优异的结果,平均差异从-0.06%到1.76%。肾切除术后6个月或1年的分裂肾体积(CT)与估计的肾小球滤过率(eGFR)之间的相关性显示出中等相关性,系数范围从0.708到0.83。SRF(MRI)和肾闪烁显像之间的相关性报告为中度相关性,相关系数为0.58和0.84。MRI和闪烁显像显示出良好的一致性,观察到66%的一致性和±0.3%的平均差异。
结论:尽管研究存在异质性,与闪烁显像相比,基于MRI或CT的肾功能测定似乎很有希望,具有良好的相关性和一致性。