胰肾联合移植术后多层螺旋CT表现

Multi-slice CT Findings in Simultaneous Pancreatic Kidney Transplantation

目的应用多层螺旋CT(MSCT)及其后处理技术评价胰肾联合移植术后移植物的影像学表现及并发症的征象。资料与方法14例行胰肾联合移植术的患者作16次MSCT检查。采用GELightspeed16螺旋CT扫描仪,行平扫及增强扫描,然后将所有图像传入GE AW4.0工作站进行多平面重建(MPR)、最大密度投影(MIP)及容积再现技术(VR)进行后处理。结果14例移植胰腺中,MSCT显示12例胰腺实质正常,CTA显示胰腺血管无狭窄及栓塞等异常;1例移植胰腺右侧髂外动脉近起始部至股动脉处血栓形成,胰腺体积小、密度低,未见明显强化,术后病检示胰腺内脾动脉血栓形成,胰腺缺血坏死及胰腺急性排斥反应;1例胰腺包膜下积液。14例移植肾显示11例肾实质正常,1例动脉期肾皮髓质分界欠清晰,提示为轻度急性排斥反应,后亦经肾穿刺所证实;1例MIP显示2处移植肾动脉狭窄;另1例显示移植肾静脉瘤形成。7例患者中MSCT均可见胰周、肾周少量积液。结论MSCT以及后处理技术能对胰肾联合移植术后移植胰腺和肾脏形态及基本功能状态作出评估。

Objective To evaluate the value of Multislice CT （MSCT） and postprocessing techniques in evaluation of CT findings and complications after simultaneous pancreatic kidney transplantation. Materials and Methods 16 times of MSCT imaging were performed in 14 patients with simultaneous pancreatic kidney transplantation with a MSCT scanner （GE Lightspeed 16 CT） before and after enhancement. Source images were transported into a workstation to reconstruct MIP and VR. Results In 14 cases of transplant pancreases, MSCT found 12 normal pancreas parenchyma, 1 case with thrombosis from original site of right external iliac to femoral artery, the size of pancreases were small with hypodensity, nonenhancement, the thrombosis of intrapancreatic splenic artery was found with necrosis and acute rejection, 1 case with subeapsular fluid collection. In 14 cases of transplant kidneys, MSCT identified 11 normal kidneys and 1 case with slightly acute rejection and MSCTA detected 2 sites of transplant renal arterial stenosis in 1 case and 1 venoma in another by MIP. Small amounts of peripancreatic and perirenal fluid collections were found in 7 patients. Conclusion MSCT with its postprocessing technique is helpful for evaluation of complications after simultaneous pancreatickidney transplantation.