64层CT对亲体供肾者术前的综合评价

The value of 64-slice CT in preoperative evaluation for allograft-kidney donor

目的研究64层CT对亲体供肾者术前的综合评价。方法38例肾移植前亲体供肾者行64层CT增强扫描,将所获得的图像重建后传入工作站,采用最大密度投影(MIP),多平面重建(MRP),容积再现(VR),曲面重建(CPR)及CT尿路成像(CTU)等技术对肾动脉、静脉、两侧肾盂、肾盏、上尿路进行多种方法重建,了解供体肾血管及上尿路解剖结构、肾脏分泌功能等。结果 38例亲体供肾者,25例双肾均由单支肾动脉供血,有2例双侧均由2支肾动脉供血,2例左肾动脉早期分支,9例副肾动脉,其中7例一侧副肾动脉(右肾4例,左肾3例),2例为左右各一支副肾动脉。右肾静脉2支2例,1例左侧卵巢静脉粗大管径约7.0mm入左肾静脉;所有38例检查影像所见与手术结果相一致。结论 64层CT增强扫描能较好显示亲体供肾者血管及尿路、肾实质与周围脏器的空间立体关系;可作为亲体供肾者肾移植术前评估及手术方案的制定具有指导作用。

Objective To study the role of 64-slice CT in preoperative evaluation for allograft-kidney donor.Methods 38 cases of kidney donors underwent contrast-enhanced 64-slice CT scan,the data set were transmitted to workstation and the postprocessing technigues,such as MIP,MPR,VR,CPR,CTV were used to depict reral artery,vein,pelvis and calyx.The renal excretory function was also evaluated.Results Of 38 cases of Kidned donors,25 cases had bilateral Kidneds supplied by single artery,2 cases had bilateral kidneds supplied by 2 arteries,2 cases left kidned artery biforcated early,9 cases had accessory artery,of which 7 cases were unilateral（4 cases in right,3 in left）,2 cases were bilateral,2 cases had 2 veins,1 cases showed wide left ovarian vein,the luminal diameter was about 7.0mm,draning into left reral vein;all the imaging finds were proved by surgery.Conclusion contrast-enroanced 64-slice CT could provide excellent quality of image to demoustrate blood vessels,pelvicaliceal system,renal parenchyma and the relationship with adjacent structures,so it could be used to evaluate donor kidney properatively and be useful for surgical planning.