APPROVAL

This is to certify that Mr. Rabin Paudel has carried out this project work entitled
“MEASUREMENT OF RENAL PARENCHYMAL THICKNESS IN CT ABDOMEN
IN PATIENTS WITHOUT RENAL DISEASE” under our direct guidance and
supervision. The project work done and the data incorporated in this connection are
original.

This project work is prepared as partial fulfillment of the requirements for the Degree of
Bachelor of Science in Medical Imaging Technology (B.Sc.MIT) course from Tribhuvan
University, Institute of Medicine, Maharajgunj Medical Campus, Kathmandu, Nepal. This
project work has been accepted and recommended for final approval.

…………………………….…........
Guide
Assoc.Prof. Mukunda Psd. Humagain
Department of Radiology and Imaging
TU Teaching Hospital, Maharajgunj
Kathmandu, Nepal
……………………………................
Guide
Asst.Prof Dr. Sharma Paudel
Department of Radiology and Imaging
TU Teaching Hospital, Maharajgunj
Kathmandu, Nepal
 CERTIFICATE

This is to certify that, this project work entitled “MEASUREMENT OF RENAL

PARENCHYMAL THICKNESS IN CT ABDOMEN IN PATIENTS WITHOUT
RENAL DISEASE” has been carried out by Mr. Rabin Paudel in the Department of
Radiology and Imaging of Tribhuvan University Teaching Hospital, Kathmandu under our
direct guidance and supervision.

This project work is being submitted to Tribhuvan University, Institute of Medicine,

Maharajgunj Medical Campus in partial fulfillment of the regulations for the award of
Degree of Bachelor of Science in Medical Imaging Technology (B.Sc.MIT).

…………………………………………
Prof. Dr. Benu Lohani
Head of Department
Department of Radiology and Imaging, TUTH
Date ………………………..
 DECLARATION

I hereby declare that, this project work entitled “MEASUREMENT OF RENAL

PARENCHYMAL THICKNESS IN CT ABDOMEN IN PATIENTS WITHOUT
RENAL DISEASE” has not been submitted in candidature for any other degree. This
project work was performed by me under the supervision of my guides. I don’t have any
objection for the availability of this project work for photocopy and inter-library loans for
external use.

…………………
Rabin Paudel
B.Sc.MIT 3rd year
Roll no.: 100
 ACKNOWLEDGEMENT

I would like to express my profound gratitude to Assoc. Prof Mukunda Prasad Humagain
and Asst. Prof Dr. Sharma Paudel for their constant supervision throughout my project with
their constructive and creative feedback as well as for providing necessary information
regarding the project and also for their support in completing the project work.

I would like to express my special gratitude and thanks to Mr.Saroj Chhetry for his vital
support and assistance throughout my project work despite his busy schedule.

Similarly, I would like to express my sincere words of thanks to Mr.Sudil Paudyal, Mr.
Damodar Rokka, Mr. Deepak Bhusal, Mrs. Pooja Shah and to all my teachers as well as
colleagues who helped me at various point of time and persistently encouraged me to
execute my project work.

I would like also like to express my gratitude towards my parents without whom I was
nothing; they not only assisted me financially but also extended their support morally and
emotionally.

Lastly, I would like to thank all the staff and students of the radiology department and all
the participants for their kind cooperation.

Rabin Paudel
 Abbreviations

ALARA As low as reasonably achievable

BMI Body Mass Index
CT Computed Tomography
CTU CT urography
CRD Chronic renal disease
CTDI CT Dose Index
DFOV Display Field of View
HU Hounsfield Unit
IOM Institute of Medicine
IVU Intravenous urography
KL Kidney Length
kVp Kilovoltage Peak
LCD Liquid crystal display
LOCM Low osmolar contrast media
MPT Medullary pyramidal thickness
MRI Magnetic resonance imaging
Lp/cm Line pair per centimeter
mAs Miliampere second
MDCT Multidetector CT
PACS Picture Archiving and Communication System
RL kidney length
RPT Renal parenchymal thickness
SD Standard deviation
SFOV Scan field of view
ST Slice thickness
TV Tube voltage
TUTH Tribhuvan University Teaching Hospital
US Ultrasound
3D Three dimensional
 ABSTRACT
Objective: Renal parenchymal thickness is the important parameter to identify chronic
renal disease. The objective of our study was to evaluate the thickness of renal parenchyma
of both kidneys in CT abdomen.
Methodology: This prospective cross-sectional study was done in 96 patients who
underwent CECT Abdomen examination for indication other than renal pathology in
Tribhuvan University Teaching Hospital (TUTH) from June to September. CT scans were
performed on the Siemens Somatom Definition AS+ 128 slice CT scanner. Each kidney
was divided into three poles that is upper, middle and lower. Renal parenchyma thickness
was measured for these poles in venous phase images. Correlation of renal parenchyma
thickness was also done with age, sex, height, weight and BMI. Correlation analyses was
performed using the method of Karl-Pearson.
Results: Mean renal parenchymal thickness (RPT) for right kidney was1.931±0.253 and it
was 1.9610±0.255 cm, 1.8970±0.2514cm, 1.93458±0.2570 cm at upper pole, middle pole
and lower pole respectively. Mean renal parenchymal thickness for left kidney was
1.9482±0.260 and it was 1.9795±0.2620 cm, 1.9044±0.2651cm, 1.9594±0.26993cm at
upper pole, middle pole and lower pole respectively. Renal parenchyma thickness of left
kidney was greater than that of the right kidney (p<0.01). The RPT of the upper pole was
greatest and that of the middle pole was the lowest. There was statistically no significant
difference between the RPT of male and females. The RPT of males was calculated to be
1.9482 cm whereas the RPT of females was 1.9128. There was negative correlation
between the RPT and age (r=0.89 ,p<0.01). Correlation of RPT was significant with height,
negligible with weight and negative with BMI.
Conclusion: The calculated RPT was more in left kidney. No significant difference was
noted between the RPT of male and female. RPT decrease with increasing age.
Keywords: CECT abdomen, Kidney, Pole, RPT
 TABLE OF CONTENTS
TOPICS PAGE NO.
1. INTRODUCTION 1
2. OBJECTIVES 3
2.1. General Objective 3
2.2. Specific Objective 3
3. THEORY 4
3.1. Anatomy 4
3.2. General Structure of the Kidney 8
3.3. Developmental abnormalities and variant 14
3.4. Radiological features of the kidney 15
3.5. Basic principle of CT 19
3.6. Multiple-Row Detector Helical CT 25
3.7. Helical Pitch 26
3.8. Advantages of Multiple-Row Detector CT 26
3.9. CT technique of routine abdomen and pelvis 27
4. LITERATURE REVIEW 33
5. METHODOLOGY 36
6. RESULTS 41
6.1. Population Statistics 41
6.2. Correlation 46
7. DISCUSSION 50
8. LIMITATION OF STUDY………………………………………………………. 52
9. CONCLUSION 53
10. REFERENCE 55
11. APPENDIX-I 59
12. APPENDIX II 61

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 List of figures
Figure No Name Page No.
1. Anterior aspect of urinary system in relation to surrounding 4
structure a. Abdominal structures & b. Bony structures
2. Lateral aspect of urinary system in relation to surrounding 5
structures.

3. Longitudinal section of kidney 8

4. Structure of Nephron 10
5. Renal circulation 13
6 Principle of CT 20
7. Principle of Helical CT 23
8. Scan selected for measuring the RPT 39
9. Method used in measuring RPT 39
10. Distribution of sex in the study 41
11. Age-wise distribution in the study 42
12. Mean RPT of both kidneys in Upper, Middle, Lower pole 44

13. Mean RPT of both kidney of male and female 45

14. Scatter diagram showing relation of age and RPT 46
15. Scatter diagram showing relation of height and RPT 47
16. Scatter diagram showing relation of weight and RPT 48
17. Scatter diagram showing relation of BMI of patients and RPT 49

List of Tables
Table No. Name Page No.
1. r value and strength of correlation 40

2. Mean, SD and range of height and weight gender wise 42

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3. Descriptive statistics of different poles of right kidney. 43

4. Descriptive statistics of different poles of left kidney 43

5. Distribution of mean, SD of both RPT in male. 44

6. Distribution of mean, SD of both RPT in female. 45

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