螺旋CT血管成像与后处理技术对活体供肾血管的评估

Evalution of renaal vessels in living donors by three-dimensional computed tomography

目的评价螺旋CT三维重建技术在亲属活体供肾血管术前评估的价值.方法2004年10月～2005年11月亲属活体供肾移植术6例,术前行螺旋CT血管造影.采集的轴位图像数据传入影像工作站,分别使用VR、MIP和MPR技术进行图像后处理,评估供肾血管状况,并与肾移植取肾手术相对照.结果VR技术后处理显示肾动静脉主干及2～3级分支（6/6）,副肾动脉（0/3）,肾静脉走行变异（1/1）,双侧下腔静脉（1/1）;MIP、MPR技术后处理均显示肾动、静脉主干及2～4级分支（6/6）,副肾动脉（3/3）,肾静脉走行变异（1/1）,左肾静脉2支属支（1/1）,双下腔静脉（1/1）.图像后处理综合结果与取肾术中所见完全一致,敏感性和准确性均为100%.结论MIP及MPR技术观察细小血管分支优于VR.SCTA及图像后处理技术,术前可替代DSA对亲属活体供肾血管作准确评估.

Objective To evaluate the renal vessels of living donors with spiral CT using three - dimensional reconstruction.Methods Between October 2004 and November 2005, six renal donors underwent spiral CT angiography. All the images were reconstructed by volume rendering（ VR ）, maximum intensity projection（MIP）, and multiplanar reconstruction（MPR） techniques. The anatomical locations of renal arteries and veins were assessed. Findings at CT were compared with those at surgery. Results All the imaging post - processing techniques displayed the trunks and 2- 3 grand branches of renal vessels （6/6）. Vein anomalies were displayed in two cases（2/2）. Three accessory renal arteries（3/3） were missed in VR. By Combined axial with 3 - D reconstruction, the sensitivity and accuracy of CT angiography for renal vascular anatomy were 100%. Conclusion MIP and MPR are more sensitive to the branching of renal vessels than VR. CT angiography with 3 - D reconstruction on technique is accurate for the preoperative evaluation of renal vessels in living donors.