螺旋CT三维成像评估活体供肾血管

背景：术前供肾血管的影像学评估对选择合适供肾及决定手术方式至关重要。目的：评估16层螺旋CT血管显影对活体供肾血管的显示水平。方法：术前对59例活体供肾者进行CT血管显影检查,三维重建肾脏动脉显像,由放射科医师评估血管情况,并与术中描述的血管情况对比。分析CT血管显影检查肾脏血管的敏感性和准确度。结果与结论：螺旋CT血管显影检查肾动脉总的敏感性和准确度分别为96.6%,90.5%。50例供肾为单支动脉,螺旋CT血管显影诊断的敏感性和准确度分别为96.1%,92.9%。在6例有两支肾动脉供肾中,螺旋CT血管显影敏感性和准确度均下降为83.3%。3例供肾有3支肾动脉,螺旋CT血管显影的敏感性和准确度为66.7%。螺旋CT血管显影对多支肾动脉总的诊断准确度为77.7%。说明无创、立体直观的螺旋CT血管显影检查可以准确地预测90.5%以上供肾动脉血管情况,是供肾术前血管评估的较好手段。

Preoperative evaluation of living donor renal vassels with three-dimensional 16-section computed tomography angiography

BACKGROUND：Preoperative imaging for evaluation of donor renal vessels is necessary to select a suitable donor and to plan an operative method. OBJECTIVE：To evaluate the sensitivity of 16-section CT angiography （CTA） as the primary imaging technique in preoperative living kidney donors. METHODS：A total of 59 cases had been evaluated preoperatively by 16-section CTA with 3-D reconstruction. Arterial anatomy described by skilled radiologists was compared with intraoperative findings. The sensitivity and accuracy of CTA examination of the renal vascular were analyzed. RESULTS AND CONCLUSION：Totally,the sensitivity and accuracy of CTA in renal artery were 96.6% and 90.5%,respectively. Fifty donors were found to have single kidney artery during operation. For these donors,the diagnostic sensitivity and accuracy of CTA were 96.1% and 92.9%,respectively. In 6 donors with two renal arteries,the sensitivity and accuracy of CTA both decreased to 83.3%. In 3 donors with three renal arteries,the sensitivity and accuracy of CTA were both 66.7%. The total diagnostic accuracy of 16-section CTA for multi-vessel renal artery was 77.7%. The noninvasive and three dimensional visual 16-section CTA examination can accurately and clearly predict arterial vasculature in more than 90.5% of donors. It is also a better means for preoperative vascular assessment.