16层螺旋CT三维重建对活体供肾的评估价值  

Evaluation of the kidney in living donor with 16 detector-row helical CT with 3-dimensional reconstruction

作　　者：何宝明[1] 由昆[2] 李红[2] 乔远罡[2] 李强[2] 王钦媛[2] 田梅[2] 许国宇[2] 

机构地区：[1]解放军总医院第二附属医院核医学科,北京100091 [2]解放军总医院第二附属医院放射科,北京100091

出　　处：《解放军医学杂志》2009年第7期883-884,共2页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨16层螺旋CT三维重建在活体供肾血管解剖、肾功能评估中的应用价值。方法使用飞利浦Brilliance 16层螺旋CT扫描机对37例活体供肾者术前行螺旋CT扫描,采用容积再现技术(VR)、最大密度投影(MIP)、多平面重建(MPR)、曲面重建(CPR)重建方法进行肾血管及肾实质的三维重建技术,使用层块体积测量方法测量肾脏体积并与肾小球滤过率(GFR)进行比较,测量肾动脉直径并与GFR进行比较。结果螺旋CT三维重建血管造影显示肾脏血管的准确性为89.2%,在各种三维重建方法中,VR在显示肾脏血管全貌、不同角度观察血管方面比较清晰,MPR显示肾脏实质较好。MIP结合轴位图像在判断血管分支,确定血管数量和显示血管有无异常方面比较准确,肾脏体积与GFR呈正相关,肾动脉直径与GFR无明显相关性。结论螺旋CT三维重建技术在显示血管、肾实质及肾脏功能的评估中有明显作用。Objective To assess the application of 16 detector-row helical CT with 3-dimensional reconstruction for the evaluation of the size, arterial anatomy and function of the kidney in living donors. Methods Thirty-seven living renal donors were examined with PHILIPS 16-row helical CT before operation. Each donor was evaluated preoperatively with CT angingraphy （CTA） with 3-dimensional reconstruction, from which VR, MPR, CPR, MIP of the renal artery and renal parenchyma were documented. Artery anatomy described by two staff radiologists was compared with intraoperative findings. Renal artery diameter and renal volumes were measured and compared with glomerular filtration rate （GFR）. Results The accuracy of helical CTA with 3-dimension reconstruction for predicting arterial anatomy was 89. 2%. Renal vessels and spatial interrelationships were displayed well by VR, renal parenchyma was displayed well by MPR, and MIP combined with axial image was more sensitive to display the branches of renal vessels than VR and MPR. Renal volume showed a positive linear correlation with GFR, while no obvious correlation was found between renal artery diameter and GRF. Conclusions Helical CT with 3-dimensional reconstruction is very useful for the evaluation of renal size, renal function and renal arterial anatomy of the kidney in living donors.

关 键 词：肾移植 活体供者 CT血管三维成像 计算机断层 

分 类 号：R617[医药卫生—外科学]