64层螺旋CT血管造影术对肾区巨大肿瘤诊断的应用价值

目的探讨64层螺旋CT血管造影术(CTA)在肾区巨大肿瘤诊断中的应用价值。方法回顾性分析30例肾区巨大肿瘤患者术前CTA资料。利用血管三维重建技术,显示肿瘤供血动脉来源、数目及变异血管情况,肿瘤病变对邻近肾内动脉分支的影响及肾动脉有无变异等。结果 30例患者CTA资料均可清晰显示腹主动脉、脾动脉、肠系膜上动脉、肾动脉等血管的解剖结构,其中可见肿瘤血管26例(86.7%),变异性血管13例(43.3%),侧支血供9例(30.0%),肿瘤染色14例(46.7%),动静脉瘘7例。21例(70%)显示4个左肾段动脉,9例(30%)显示5个左肾段动脉;17例(56.7%)显示4个右肾段动脉,12例(40%)显示5个右肾段动脉。结论 CTA结合三维重建技术可多方位立体观察肾区肿瘤血管解剖结构及变异,并清晰显示病变与周围血管的关系,为临床手术提供可靠的信息。

The clinical application of 64-slice spiral CT angiography in giant renal region tumors

Objective To investigate the value of 64-slice spiral CT angiography （ CTA ） in diagnosis of giant renal region tumors. Methods 64-slice spiral CTA was performed before operation in 30 patients with giant renal region tumors. The vessels supplying tumors and variations of renal arteries adjacent to renal region tumor were observed on the post-processing three-dimensional reconstruction images. Results The abdominal aorta, splenic artery, superior mesenteric artery and renal artery were clearly shown in 30 patients. Visible vessels supplying tumors were shown in 26 cases （86.7%）, variations of renal arteries in 13 cases （43.3%） , collateral blood supply in 9 cases （30.0%）, tumor staining in 14 cases （46.7%）, arterial venous fistula in 7 cases. There were 4 and 5 left renal segmental arteries in 21 and 9 patients （70% and 30%）, 4 and 5 right segmental arteries in 17 and 12 patients （56.7% and 40%）. Conclusion CTA combined with 3-dimensional reconstruction techniques can give all-round and stereoscopic view of vascular anatomy and variations of renal region tumors, clear display lesions and its adjacent vessels, and provide reliable information for clinical surgery.