动脉晚期CTA融合图像在肾动静脉系统评估中的价值

目的探讨动脉晚期CTA融合图像在肾动静脉系统评估中的价值。方法26例超声提示肾占位的病人及5例活体供肾者,采用德国Siemens Somatom Sensation 16层螺旋CT机,进行了平扫及动脉早期、动脉晚期及实质期3期增强扫描。数据被传到GE ADW 4.2 Workstation进行3D重建,采用Volume viwer plus voxtool 6.3.19软件包。由2位放射科主任医师对肾动静脉系统显示情况进行评估,意见相左时,通过讨论达成共识。结果动脉晚期CTA融合图像对副肾动脉和肾动脉提前分支的显示率与动脉早期相同。左右肾副肾动脉的CTA显示率分别为32.3%和6.5%。左右肾动脉提前分支的显示率分别为12.9%和9.7%。对环主动脉左肾静脉、腹主动脉后左肾静脉及多条右肾静脉,动脉晚期CTA融合图像与实质期的显示率之间亦无差异,分别为16.1%、3.2%及32.3%。动脉晚期CTA融合图像对左肾上腺静脉、左性腺静脉及左腰静脉的显示率为83.9%、87.1%、61.3%,和实质期相比(分别为87.1%、93.5%、64.5%),2组之间无统计学差异(P>0.05)。动脉晚期CTA融合图像质量优于实质期。结论动脉晚期CTA融合图像能够同时且清楚地显示肾动静脉系统,减少了受检者的放射线剂量、节约了检查时间。

The Value of CTA Fused Images of the Late Arterial Phase Scanning in the Assessment of Renal Artery and Vein System

Objective To discuss the value of CTA with fusion imaging technique in assessment of renal artery and vein system.Methods twenty-six patients with suspected renal lesions by ultrasonic examination and 5 volunteers underwent German Siemens Somatom Sensation 16 MDCT examination,including plain CT scan and the early arterial phase,late arterial phase and parenchymal phase scan.Then the data were transferred to GE Workstation ADW 4.2 for 3 D reconstruction with the software packages of Volume viwer plus voxtool 6.3.19.Two radiologists assessed all CTA images of demonstrating renal artery and vein system.When disagreement was encountered,agreement was reached through discussion.Results CTA of the late arterial phase with fusion imaging technique was same to CTA of the early arterial phase in detection of accessory renal artery and early branches of renal artery.The detected rate of accessory renal artery of left and right kidney was 32.3% and 6.5% respectively,while for the early branches of left and right renal artery was 12.9% and 9.7% respectively and for the circumaortic left renal vein,the retroaortic left renal vein and multi right renal vein was 16.1%,3.2% and 32.3% on the late arterial phase respectively.No further information was found on the parenchymal phase.The detected rate of the left adrenal vein,the left gonadal vein and the lumbar vein on late arterial phase images was 83.9%,87.1% and 61.3%,corresponding to the parenchymal phase scanning(87.1%,93.5% and 64.5%,respectively),and no statistical significance was found between them(P>0.05).The CTA image quality of the late arterial phase with fusion imaging technique was superior to that of the parenchymal phase.Conclusion CTA of the late arterial phase with fusion imaging technique can demonstrate renal artery and vein system simultaneously and helpful to reduce radiation dose of patients and save examination time.