亲属供肾血管三种影像学方法的评价

Evaluation of three imaging methods for renal arteries in living related donors

目的对照多层螺旋CT血管成像(MSCTA)、磁共振血管成像(MRA)及数字化减影肾血管造影术(DSRA)评价亲属供肾血管准确性。方法28例亲属供肾者,16例采用DSRA,6例采用MRA,6例采用MSCTA评价其肾血管情况。将三种影像的检查结果与术中所见对比。结果28例供者共显示肾动脉60支,16例DSRA检查中,13例显示双肾单支动脉血供,2例左肾单支极血管,1例右肾单支极血管;6例MRA检查中,均显示双侧单支肾动脉血供,但手术证实有1例伴左肾上极动脉和1例左肾动脉早期分支;6例MSCTA检查中,1例右肾单支上极动脉,另1例左肾动脉早期分支。结论本组资料显示术前采用DSRA及MSCTA进行供肾血管评价与手术所见一致,准确性较MRA高;MSCTA可作为亲属供肾术前血管无创评价的首选方法。

Objective： To evaluate the application and accuracy of multislice spiral CT angiography （MSCTA）, magnetic resonance angiography （MRA） and digital subtraction renal angiography （DSRA） for renal arteries in living related donors. Methodology：Renal arteries were evaluated in 28 living donors. DSRA were used in 16 donors, MRA were used in 6 donors and MSCTA were used in 6 donors, The results were compared with that in surgery, and the accuracy of MSCTA, MRA and DSRA were compared. Results：Sixty renal arteries were displayed in 28 donors, DSRA in 16 donors, 13 cases were demonstrated bilateral renal to be all supplied ＋ by single renal artery, of them, 2 donors had single left renal accessory artery respectively, another 1 donor in fight renal, The findings agreed with the surgical results. MRA in 6 donors, all of them were displayed bilateral renal solitary artery, but single uppermost left renal accessory artery in one donor and a left renal prehilar branch in another donor were approved at operation, MSCTA in latest 6 donors, 4 cases were showed all single artery in bilateral renal, one donor had single right renal accessory artery and one had a left renal prehilar branch. The same findings were confirmed in surgery. Conclusion：The results of DSRA and MSCTA were corresponding to that in surgery and more accurate than that of MRA. Moreover, MSCTA can substitute DSRA for no injury, convenience and economical, and as accurate as DSRA. MSCTA can be the preferred in evaluating renal vascular in living related donors.