多层螺旋CT在活体肾移植供体术前综合评估中的价值  

The value of multi-slice spiral CT in the preoperative assessment of living renal donor

作　　者：李清海[1] 严福华[1] 朱同玉[2] 许明[2] 徐鹏举[2] 周梅玲[1] 王国民[1] 

机构地区：[1]复旦大学附属中山医院放射科,上海200032 [2]复旦大学附属中山医院泌尿外科,上海200032

出　　处：《中华放射学杂志》2008年第4期387-391,共5页Chinese Journal of Radiology

摘　　要：目的探讨多层螺旋CT（MSCT）在活体。肾移植供体术前综合评估中的价值。方法36名活体亲属供。肾者术前均行MSCT扫描，前25名行平扫及动脉早期、动脉晚期、排泄期3期增强扫描（对比剂注射流率5ml／s，总量100ml，管电压120kV），后11名行平扫（100kV）及血管期、排泄期（100kV）双期增强扫描（对比剂以2ml／s流率注射40ml，以4ml／s流率注射60m1），均采用排泄期的数据进行Cr尿路成像（CTU）。将图像与经手术证实的33名受检者术中所见对照，评价MSCT在评估供。肾血管、尿路及。肾实质情况的价值。对2组不同参数扫描的三维（3D）重组图像质量采用Mann—whitneyU精确检验。结果CT血管成像（CTA）对供。肾动静脉主干、副。肾动脉、动脉提前分叉、肾静脉主干变异、左。肾静脉属支和交通支及CTU对尿路的显示与术中一致。2组三维（3D）血管重组图像质量评分分别为（4．4±1．2）和（4．2±1．3）分，CTU重组图像质量评分分别为（4．6±0．8）和（4．4±0．9）分，差异均无统计学意义（Z值分别为-0．89、-0．47，P值均〉0．05）。结论MSCT可以直观、准确地评价活体供。肾者的血管、尿路及。肾实质的情况，在活体供。肾术前综合评估中起着重要作用。Objective The purpose of this study is to assess the value of multi-slice spiral CT （MSCT） in the preoperative evaluation of living renal donor as a all in one modality. Methods Thirty-six potential living renal donors underwent the examination using a GE light VCT scanner. Informed consent was obtained from all participants. The plain scan, early arterial phase, late arterial phase and excretory phase scans are performed in the former 25 donors （ injection rate 5 ml/s, total volume 100 ml, tube tension 120 kV）. While in the later 11 donors （2 ml/s 40 ml ±4 ml/s 60 ml）, the scanning protocol included the plain scan （ 100 kV） , vascular phase and excretory phase scans （ 100 kV）. The excretory phase data were used in the reconstruction of CT urography in both groups. All images were reviewed by one radiologist and one urologist, and the findings of MSCT were compared with intraoperative findings for 33 donors, to investigate the utilities of MSCT in assessing renal vascularity, urinary tract and lesions of renal parenchyma. When discrepancies are found between the two reviewers, consensus was obtained via discussion. Au data was statiscally processed with SPSS for Windows. Results MSCT angiography is in accordance with intraoperative findings in demonstrating the anatomy of renal arteries and renal vein trunk, accesary arteries, early branching of renal artery. The findings from CTA are highly in accordance with the intraoperative findings, which facilitate intraoperative ligation and reduce relevant complications. CTU demonstrates the anatomy of urinary tract in good agreement with the intraoperative findings. The image quality of 3D vascularity and CTU between the two groups, scored 4.4 ± 1.2 vs 4. 2 ± 1.3 and 4.6 ± 0. 8 vs 4.4 ± 0.9 respectively, no statistical between-groups difference was found （ Z = - 0. 89, - 0.47, P 〉 0. 05 ）. Conclusion MSCT multiphase scanning combined with CTA and CTU play a important role in the evaluation of living renal donor, which preoperatively provid

关 键 词：肾移植 体层摄影术 X线计算机 尿路造影术 

分 类 号：R686[医药卫生—骨科学]