左肾静脉及其属支的MSCTA

目的：探讨左肾静脉及其属支的64层MSCTA技术及其影像表现。方法：分析连续100例患者MSCT增强扫描动脉期和静脉期图像上左肾静脉及其各属支的显示情况。MSCT检查采用64层CT机,0.625mm×64i方式采集,0.625mm层厚回顾性重建,标准或软组织算法;对比剂剂量80～90ml,注射流率3～4ml/s,延迟时间动脉期为25～26s、静脉期50～60s。后处理采用三维正交多平面重组（OMPR）、最大密度投影（MIP）和容积再现（VR）三种方法。结果：MSCTA动脉期和静脉期图像上均完整显示左肾静脉主干,静脉期图像上对其3个属支的显示数量（276支）多于动脉期（217支）。VR图像显示这些血管最好。69%的病例为标准的单支左肾静脉和3个属支（肾上腺静脉、生殖腺静脉和腰静脉）,31%的病例有不同程度的变异,部分病例可清楚显示膈静脉（23例）和肾包膜静脉（27例）的汇入。结论：MSCTA静脉期图像结合三维重组技术可以清晰显示左肾静脉及其属支,其中以VR图像最佳;大部分受试者的左肾静脉及属支为标准的单支型,但变异类型较多。

Three-dimensional MSCT angiography for left renal vein and its tributaries

Objective：To study the techniques of 64-MSCT angiography in evaluating the displayment of left renal vein（LRV）and its tributaries.Methods：One hundred consecutive cases of left renal vein with its tributaries were studied with enhanced 64-MSCT scanning during the arterial and venous phases.The acquisition parameters for scanning were 0.625mm×64i,0.625mm slice-thickness,standard or soft algorithm,80~90ml contrast medium with a injection rate of 3~4ml/s,25~26s delay for arterial phase and 50~60s delay for venous phase.The postprocessing included orthogonal multiplanar reformation（OMPR）,maximum intensity projection（MIP）and volume rendering（VR）.Results：The main LRV was clearly displayed both in arterial and venous phases,but the 3 tributaries were better shown in venous phase with opacification of 276 branches more than 217 branches in arterial phase;but the best vascular opacification were carried out through VR.69% cases showed the standard pattern of single LRV and 3 tributaries（adrenal vein,gonadal vein and lumbar vein）and the other 31% cases revealed various degree of anomaly in variants including some with clear convergence of phrenic vein（n=23）and renal capsular vein（n=27）.Conclusion：The three-dimensional MSCT angiography could clearly reveal the LRV and its tributaries in detail during venous phase but especially best with VR.Standard single LRV with tributaries contributes the main pattern in the majority but the variants exist exclusively.