99mTc-DTPA肾显像联合64排螺旋CT血管造影对亲属活体供肾肾功能和血管评价的临床应用

目的 探讨99mTc-DTPA肾动态显像及64排螺旋CT血管造影(CTA)在活体肾供体术前对供肾肾功能和血管情况评价的应用价值。方法 38例拟行亲属活体供肾者活完成了99mTc-DTPA肾动态显像并定量测定分肾GFR,其中26例进行了同期64排螺旋CT检查,并做容积再现(VR)、曲面重组(CPR)、多平面重组(MPR)、最大密度投影(MIP)等后处理技术以观察肾实质、肾动脉、肾静脉情况,测量肾动脉主干长度。结果 左、右肾GFR分别是(55.14±3.42)ml/min和(51.32±3.97)ml/min (p>0.05) ,GFR小于35 ml/min者有3例3个分肾（2个左肾,1个右肾）（11.5%）。CTA显示17例双肾动脉单支型（65.3%）,6例双支型(23.1%),肾内结石1例,左、右肾动脉主干长分别为(2.9±1.0)cm 和(4.2±1.1)cm (p>0.05),肾动脉主干长度小于2.0cm者有3例（11.5%）4个分肾（1例左肾、1例右肾、1例双肾）(7.7%)。结论 99mTc-DTPA肾动态显像结合64排螺旋CT血管造影能全面、准确、客观、非创伤性地评价亲属活体供肾血供、功能和血管情况。

Clinical application of 99mTc-DTPA renal dynamic imaging combined with 64-slice Spiral CT Angiography in preoperative evaluation for living related renal donors

【Abstract】0bjectives To investigate the value of 99mTc-DTPA renal dynamic imaging combined with 64-slice Spiral CT Angiography (64-SCTA)in preoperative comprehensive evaluation of living related renal donors．Methods Thirty-eight potential living related kidney donors underwent 99mTc-DTPA renal dynamic imaging before operation, of which 26 cases were evaluated with 64-SCTA, scans were reconstructed for VR,CPR,MPR,MIP in the work station．Results the GFR of left and right kidney was (55.14±3.42)ml/min and (51.32±3.97)ml/min respectively(p>0.05), GFR was less than 35.0ml/min were found in 3 cases with 3 kidneys(11.5%). CTA showed bilateral renal artery showed single-branch in 17 cases(65.3%),bilateral renal artery was double-branch in 6 cases(23.1%)．Average length of left and right renal artery was (2.9±1.0)cm and (4.2±1.1)cm respectively (p>0.05),with 4 renal arteries (7.7%) in 3 cases(11.5%) were found shorter than 2.0cm.Conclusion 99mTc-DTPA renal dynamic imaging combined with 64-SCTA provided an accurate,non-invasive, and objective method in the comprehensive evaluation of living related renal before kidney transplant．