64层螺旋CT在活体肾移植供体术前评价中的应用

Application of 64-slice Spiral CT Angiography in Preoperative Evaluation for Living Renal Donors

目的探讨64层螺旋CT(64-SCT)在活体肾移植供体术前评价中的应用价值。资料与方法对58例活体肾移植供体应用64-SCT进行肾皮质期、实质期、排泄期扫描。所得数据传至Vitrea 2工作站,采用容积再现(VR)、曲面重组(CPR)、多平面重组(MPR)、最大密度投影(MIP)等后处理技术重组肾实质、肾血管、肾盂及输尿管图像,其中35例与取肾手术进行对照。结果58例中双肾动脉单支型40例(68.97%),双肾动脉双支型6例(10.34%)。右肾静脉单支型49例(84.48%),双支型9例(15.52%),左肾静脉单支型57例(98.28%)。双肾盂、中上段输尿管均未见明显异常。64-SCT对肾动脉、肾盂及输尿管显示的敏感性和特异性均为100%;对肾静脉显示的准确性为97.14%;对单支肾静脉显示的敏感性为100%,特异性为50%。结论64-SCT能较全面地显示供体肾实质、肾动静脉、肾盂、中上段输尿管解剖及变异,可为临床选择合适的供肾提供可靠依据。

Objective To investigate the value of 64-shce spiral CT angiography （64-SCTA） in preoperative compre- hensive evaluation of living renal donors. Materials and Methods 58 renal donors performed 64-SCTA befor operation. The original ate were reconstructed using VR, CPR, MPR, MIP in the work station. The renal parenchyma, renal vessels and upper urinary tract of 58 cases were observed. The CT findings of 35 cases were compared with operative findings. Results Bilateral renal artery showed single-branch in 40 cases（68.97% ）. Bilateral renal artery was double-branch in 6 cases （ 10.34% ）. Right renal vein was single-branch in 49 cases （ 84.48% ）. Right renal vein was double-branch in 9 cases （ 15.52% ）. Left renal vein was single-branch in 57 cases （98.28%）. Both of the sensitivety and specificity were 100% in the renal parenchyma,renal artery,pelvis and ureter with 64-SCTA. The sensitivety, specificity were 100% and 50% respectively in single-branch renal vein. Conclusion 64-SCTA can assess the renal parenchyma, renal vessels, upper urinary tract and spatial interrelationships of the kidneys and adjacent organ.