БАЛЛЬНАЯ СИСТЕМА ВИЗУАЛЬНОЙ ОЦЕНКИ РАЗДЕЛЬНОЙ ФУНКЦИИ ПОЧЕК ПРИ КОМПЬЮТЕРНОЙ ТОМОГРАФИИ

A SCORING SYSTEM FOR VISUAL ASSESSMENT OF SEPARATE KIDNEY FUNCTION IN COMPUTED TOMOGRAPHY

Currently, predictive formulas for calculating glomerular filtration rate are used in clinical practice to assess overall renal function, while renal scintigraphy data is used to determine the percentage contribution of each kidney. Proposed methods for assessing individual renal function using contrast-enhanced computed tomography (CT) data require specialized software and are time-consuming. When interpreting contrast-enhanced CT results, a radiologist typically attempts to characterize renal excretory function. However, this approach is largely subjective and relies almost exclusively on the timing of urinary tract contrast. There are no generally accepted guidelines for visually assessing renal function using CT. Purpose. To develop a scoring system for determining the degree of renal excretory dysfunction in one kidney based on a visual assessment of the nature of contrast agent accumulation by the anatomical elements of the kidneys during standard CT scanning at various contrast phases. Materials and Methods. A comparison was made between the visual images of the kidneys of 112 patients in different phases of contrast enhancement and the results of calculating their separate function, obtained during their automatic three-dimensional segmentation using a specialized workstation program. Results and discussion. A scoring system for assessing renal excretory function is proposed, assigning points (from one to three) based on the detection of unilateral changes during various contrast phases, including: decreased cortical enhancement intensity, decreased cortical thickness, decreased renal parenchyma volume, delayed onset of the nephrographic phase, and decreased contrast-enhanced urine volume. Patients with a score of 0-1 indicated little or no decline in renal function; a score of 2-5 indicated a moderate decline; a score of 6 or more indicated a significant decline in the function of the affected kidney. ROC analysis aloowed getting threshold values for the percentage contribution of the affected kidney to overall excretory function for patients with scores of 0-1/2-5 and 2-5/6 or more; these were 43.5% and 27%, respectively. Conclusion. The proposed method for visually assessing renal function, based on a scoring system, allows establishing the degree of impairment using standard computed tomography (CT) without the use of additional diagnostic techniques and with minimal time expenditure. © 2025 I.M. Sechenov First Moscow State Medical University. All rights reserved.