多层螺旋CT肾血管成像在亲属活体供肾术前评价中的应用价值

Clinical value of renal vessel angiography with 64-slice spiral CT in evaluating living donors prior to donor nephrectomy

目的:探讨64层螺旋CT肾血管成像(64-SCTRA)术前评价亲属活体供肾的临床价值。方法:拟行亲属活体供肾移植的供者84例,行64-SCTRA了解肾实质及肾脏血管情况,并将检查结果与术中所见相对照。结果:84例供者CT检查均获得满意图像。67例供者双侧肾动脉均为单支,17例供者一侧或双侧肾动脉伴有副肾动脉;14例供者发现肾动脉过早分支;肾动脉内斑块12例,其中11例管腔轻度狭窄,1例管腔中度狭窄;肾静脉双支5例。肾囊肿11例,肾结石4例,肾脏血管平滑肌脂肪瘤1例。除1例间质性肺炎、1例肾脏血管平滑肌脂肪瘤供者被剔除,其余82例行开放手术切取供肾,均获得成功。肾静脉、肾盂及输尿管64-SCTRA的检查结果与术中所见完全一致。64-SCTRA对肾动脉过早分支的检出率为100%。3例术中发现细小副肾动脉而64-SCTRA未报告。结论:64-SCTRA可对肾脏及肾血管进行充分评估,可作为供肾切取术前的常规检查项目。

Aim：To investigate the clinical value of 64-slice spiral CT（64-SCT） renal vessel angiography in evaluating living donors prior to donor nephrectomy.Methods：The data of eighty-four living donors underwent 64-SCT renal vessel angiography were reviewed and compared with the findings in donor nephrectomy,especially renal vessels and renal parenchyma.Results：Eighty-four living donors gained satisfactory CT images.Sixty-seven donors had one renal artery on each side,accessory renal arteries were found in 17 donors on one side or two sides.In addition,renal artery pro-branch was found in 14 cases.Renal artery plaque was found in 12 cases（mild renal artery narrowing was found in 11 cases,and moderate renal artery narrowing was found in 1 case）.Double renal veins was found in 5 cases.There were 11 cases of renal cysts,4 cases of kidney calculus,and 1 case of renal angioleiomyolipoma.Except 1 case of interstitial pneumonia and 1 case of renal angioleiomyolipoma,eighty-two cases of donor nephrectomy were performed.The results of renal veins and collecting system by 64-SCT was in accordance with the findings in operation.Small accessory renal arteries was missed in 3 cases before operation.Conclusion：64-SCT renal vessel angiography is a safe and effective method to evaluate renal parenchyma and renal vessels of living donors,and should be used as a routine preoperative examination for living renal donors.