MSCT肾动脉成像在肾脏占位性病变诊断和术前评估中的价值

Value of 40-slice spiral CT renal artery angiography in diagnosis and preoperation evaluation of renal occupying lesions

目的探讨MSCT肾动脉成像(CTRA)在肾脏占位性病变诊断和术前评估中的价值。方法回顾分析我院经Philips Brilliance 40层螺旋CT扫描发现肾脏占位性病变的患者42例,用后处理工作站重建肾动脉,观察病变对邻近肾动脉分支的影响、肿瘤血管及类似肿瘤染色等方面的情况,同时观察肾动脉有无变异及其它病变。结果肾细胞癌(RCC)25例,其中14例可见邻近肾动脉分支受压,10例可见肾动脉受侵,6例可见1支或多支肿瘤供血动脉;肾血管平滑肌脂肪瘤(AML)6例,其中2例可见肾动脉分支受压,1例见供血动脉;肾囊肿患者11例,1例较大者压迫邻近肾动脉及其分支,无供血动脉及肿瘤血管显示。结论 CTRA不仅有助于肾脏占位性病变的定性诊断,还能在显示肾动脉解剖及变异、健侧肾动脉有无病变等方面提供有价值的补充信息,是安全、可靠、行之有效的影像学检查方法。

Objective To discuss the value of 40slice spiral CT renal artery angiography （CTRA） in diagnosis and preo peration evaluation of renal occupying lesions. Methods 42 patients with renal occupying lesions detected by Philips Bril liance 40slice spiral CT were analyzed retrospectively. Renal arteries were reconstructed with the postprocessing work station to show influences of lesions on adjacent intralrenal arterial branches, tumor vascularity, tumor stain and so on. Meanwhile, malformation and other pathological changes of renal arteries were observed. Results The renal cell carcino ma （RCC） were 25 examples, of which 14 had neighboring renal artery compression, 10 had renal artery invasion, 6 had one or multiple feeding arteries, as well as intratumoral blood vessel or the blood pool, which were similar with the DSA tumor stain, and 1 appeared the vein of diseased kidney to reveal earlier. The angioleiomyolipoma （AML） were 6 exam pies, of which 2 had neighboring renal artery compression, 1 had one feeding artery. The renal cysts were 11 examples, neighboring renal artery compression were seen in a bigger lesion, no feeding artery or intratumoral blood vessel were de tected. Conclusion CTRA can not only be helpful in diagnosis by clearly demonstrating the relationship of the lesion with the neighboring artery branches, the lesions feeding arteries or intratumoral blood vessels, but also provide extra infor mation for the surgery by demonstrating malformation and other pathological changes, which is a safe, reliable, and effec tive imaging approach.