64层螺旋CT血管成像对副肾动脉源性肾积水的应用

Application of 64-slice Spiral CTA on Accessory Renal Artery Original Hydronephrosis

目的探讨64层螺旋CT血管成像对副肾动脉源性肾积水诊断优势。材料与方法收集本院2008.4～2010.12之间12例副肾动脉源性肾积水患者,所有患者都进行CT血管成像。采用多平面重组、曲面重建、最大密度投影、容积再现技术方法重建原始数据,分析副肾动脉形态、走形、位置、起源、与输尿管关系及肾积水程度。结果所有患者显示副肾动脉斜行或横行压迫肾盂输尿管连接部,同时均伴有不同程度肾积水,其中3例伴尿液外渗,2例伴肾排泄功能明显减低,5例伴肾结石。各例MPR、CPR、MIP及VR相互结合能够清晰、直观显示副肾动脉起源部位、走形、形态、位置、及被供应肾脏关系,同时观察到副肾动脉压迫输尿管及肾积水情况。结论 64层螺旋CTA及后处理技术对血管能够较为简便地检出副肾动脉,并根据位置、走行方向,对压迫性肾积水做出客观的诊断。

Objective To investigate diagnostic advantage of 64-slice spiral CT to accessory renal artery original hydronephrosis. Materials and methods 12 cases with accessory renalartery original hydronephrosis were collected during 2008.4-2010.12. All patients undergone CTA. Initial data were reconstructed by three-dimensional reformation, multi- planar reforlnation（MPR）, curved planar reformation（CPR）, maximum intensity projec- tion （MIP） and volume rendering technique（VRT）. The shape, location, origin, relation with ureter and degree of hydronephrosis of accessory renal artery were analyzed. Results Accessory renal oppressed the conjuction of kidney pelvis and ureter in all cases, with different degree of hydronephrosis. 3 cases also suffered with extravasation of urine, and 2 cases with renal excretory ruction reduction, and 5 cases with kidney calculi. The origin, shape, location and relation with fed kidney of accessory renal artery could be showed clearly by the combination of MRCP, CPR, MIP an VR, and also showed the ureter which oppressed by accessory renal artery and the hydronephrosis. Conclusion Combined 64- slice CTA with postprocessing technology can detect accessory renal artery, and can obiec- tively diagnose compressive hydronephrosis by the shape and location of accessory renal artery.