多层螺旋CT在正常成人活体肾的影像解剖研究

Application of multislice spiral CT for measuring the anatomy of normal living kidney in adults

目的通过测量正常活体肾的各径线值和位置,获得正常成人活体肾的影像解剖数据,为临床、科研及教学提供依据。方法 157例非肾脏疾病患者(男101例,女56例,年龄22～77岁,平均44.18岁)其中55例为肾移植供体,均经SIEMENS16层螺旋CT腹部平扫与增强后动脉期和静脉期扫描检查。对源像应用MPR、MIP及VR后处理。测量项目包括肾脏的长径、宽径、厚度以及肾动脉的直径等。为了比较男、女间和左侧与右侧之间的差异,对所获数据应用SPSS13.0软件包统计分析。结果左肾的长径、宽径及厚度分别为102.51±10.05 mm、54.13±5.87 mm、49.16±5.12 mm,右肾的长径、宽径及厚度分别为99.95±12.80 mm、50.50±4.68 mm、46.51±5.2 mm,两者比较有统计学意义(P<0.05)。男性的双肾长径、宽径及厚度均大于女性的(P<0.01)。左侧肾动脉直径为5.39±0.74 mm,右侧肾动脉直径为5.24±0.69 mm,二者比较有统计学差异(t=3.557,P<0.0001)。男性的双侧肾动脉直径均大于女性的(P<0.01)。结论多层螺旋CT后处理功能强大,图像三维立体感强,能够明确肾脏与周围组织的解剖关系,可作为活体肾解剖测量的有用方法。

Objective To investigate the CT anatomic features of normal living kidney in adults and to provide the morphologic bases for clinic,scientific research and teaching practice by measuring the longitudinal diameter,transverse diameter,and thickeness of the kidneys.Methods A hundred and fifty-seven patients（101 men,56 women,aged 22-77 years,mean age,44.18 years） with clinically ruled out renal diseases,of whom,55 cases were living kidney donors underwent abdominal examinations of precontrast and postcontrast arterial phase,venous phase and excretory phase scans on a SIEMENS Emotion 16-detector row CT unit.The source images were postprocessed by MPR,MIP and VR.The measured items included the longitudinal diameter,transverse diameter,thickeness of the kidneys and the diameter of the renal arteries.In order to compare the difference between either male and female patients or left and right kidneys,all the data were statistically analyzed by using SPSS13.0 software.Results The mean longitudinal,transverse diameter and thickeness of left kidneys were 102.51±10.05 mm,54.13±5.87 mm,and 49.16±5.12 mm,respectively,while those of right kidneys were 99.95±12.80 mm,50.50±4.68 mm,and 46.51±5.2 mm,respectively,the comparison between both was statistic difference（P 0.05）.The longitudinal diameter,transverse diameter,and thickeness of male kidneys were significantly bigger than those of female kidneys（P 0.01）.The mean diameter of left renal arteries was 5.39±0.74 mm,while that of right renal arteries was 5.24±0.69 mm,the comprison between both was statistic difference（t =3.557,P 0.0001）.The diameters of bilateral renal arteries in male patients were significantly bigger than those in femal patients（P 0.01）.Conclusion Multislice spiral CT with great postprocessing function can acquire highly stereoscopic three dimensional images and can identify the anatomic relationship of the kidney with surrounding tissues,so that it can be taken as an useful modality to measure the anatomy of living kidneys in adults.