MSCTA在肾癌保留肾单位手术中的应用

APPLICATION OF MULTI-SLICES SPIRAL CT ANGIOGRAPHY IN NEPHRON-SPARING SURGERY

目的:探讨多层螺旋CT血管成像(MSCTA)在肾癌保留肾单位手术(NSS)中的应用。方法:42例拟行NSS的患者术前行MSCTA,观察肾脏位置,肿瘤的部位、范围及与肾动静脉、集合系统的关系,肾动静脉的解剖、血管的变异、肿瘤供血动脉的来源,并与术中对照。结果:MSCTA检出患者肾动脉狭窄4例,同时显示了患侧多支肾动脉,42例共63支,其中1支肾动脉者26例、2支肾动脉者11例、3支肾动脉者5例;患侧肾动脉主干分支过早13例,与术中所见一致。MSCTA肿瘤血供类型、肿瘤供血动脉来源与术中对照诊断符合率分别为97.6%和95.2%。结论:MSCTA可直观、准确地显示肾动脉变异和病变,对指导肾脏手术有重要的临床价值。

Objective：To investigate application of multi-slice spiral CT angiography （MSCTA） in nephron-sparing surgery （NSS） of renal cancer.Methods：42 renal cancer patients underwent NSS carried MSCTA before operation to show： position of kidney, location and scope of tumor, relationships between tumor and renal blood vesseles and renal collecting system, source of tumor vessels, vascular variation, and with intiaopemtive contml.Results：MSCTA showed renal artery stenosis 4cases; And also showed multivessel renal artery： 42 cases 63 renal arteries, 1 renal artery 26cases, 2 renal arteries 1 lcases, 3 renal arteries 5 cases. Early renal artery branch 13 cases, which was identified with the findings during operation. The diagnose accordance rate about blood supply of tumor and source of tumor vessels showed by MSCTA were respectively 97.6% and 95.2% with intraolperative control. Conclusions： MSCTA can display the variation and pathological changes of renal artery directly and accurately, so has important clinical value for guiding kidney surgery.