64层3DMSCT在肾静脉异常中的应用价值  

Use of 64-slice Spiral CT Angiography of Renal Vein Imaging in Evaluating Renal Vein Abnormalities

作　　者：侯伟伟[1] 王云华[2] 蒋中标[2] 郑凯[1] 

机构地区：[1]中南大学湘雅医学院附属肿瘤医院,湖南长沙410006 [2]中南大学湘雅二医院,湖南长沙410011

出　　处：《医学临床研究》2015年第4期755-758,共4页Journal of Clinical Research

摘　　要：【目的】探讨64层多排螺旋CT（MSCT）三维血管成像（3D MSCTA）在肾静脉中的诊断价值。【方法】收集拟行活体肾移植术供肾者96例，临床可疑胡桃夹综合征者5例，行64层3D M SC T A ，了解肾脏静脉血管起始、数目、分支走行及管径大小，进一步比较3D MSCTA各种图像后处理重建方法对肾静脉异常的显示效果。【结果】双肾静脉均为一支且其起源与走行正常者66例。肾静脉变异35例：包括2条右肾静脉者4例，3条右肾静脉者2例，主动脉后肾静脉者1例，肾静脉细小（考虑可疑胡桃夹综合征）者5例，性腺静脉和或腰静脉及左肾上腺静脉（左肾静脉常见属支）汇入左肾静脉主干者20例，2条左肾静脉者3例（2条肾静脉分别与腹主动脉前后分别汇入下腔静脉者1例；1条肾静脉汇入下腔静脉、一条肾静脉汇入半奇静脉者1例；1条肾静脉汇入下腔静脉、一条肾静脉汇入左髂总静脉者1例）。与手术所见完全一致者为99例，符合率为98％（99／101）。【结论】64层3D MSCTA结合适当的后处理重建方法可满意显示肾静脉正常解剖及变异情况，是评价各种肾静脉异常的准确、安全方法。[Objective] To explore the use of 3‐dimensional 64‐slice Spiral computed tomography angiography （3D MSCTA） in the diagnosis of renal veins .[Methods] A total of 96 cases of potential live renal donor and 5 cases of clinically diagnosed nut‐cracker sign （NCS） were examined by 64‐slice spiral computed tomography angiography （CTA） .The origin ,number ,branch ,course and size of renal veins were observed .Further comparisons were made for the capacities of deciphering renal vein abnormalities on all kinds of postpro‐cessing reconstruction images of 3D MSCT .[Results]Double renal vein with normal origins and courses were found in 66 cases .Among 35 cases of renal vein variation ,there were double right renal vein （ n =4） ,triple right renal vein （ n=2） ,aortic after renal vein （ n=1） ,small renal vein with suspicious nutcracker syndrome （ n =5） ,gonadal and/or lumbar vein and left adrenal vein （left renal vein common genus branch ） entering left renal vein （ n=20） and double left renal veins （ n=3） ,including double renal vein and abdominal aorta ente‐ring before and after veins （ n =1） ,single renal vein entering inferior vena cava ＆ single renal vein entering semiazygos vein （ n =1） and single renal vein entering inferior vena cava ＆ single renal vein entering left common iliac vein （ n =1） .The operative findings were consistent completely in 99 cases with a coincidence rate of 98% （99/101） .[Conclusion]3D MSCTA and appropriate postprocessing reconstruction methods may differentiate satisfactorily normal and abnormal anatomies of renal veins .And it is an accurate and safe method of evaluating renal vein abnormalities .

关 键 词：肾移植 体层摄影术 X线计算机/方法 血管造影术/方法 肾静脉/放射摄影术 

分 类 号：R692.16[医药卫生—泌尿科学]