MSCT在活体肾移植术前评估中的应用

Multidetector computed tomography in preoperative evaluation of living kidney transplantation donors

目的:探讨MSCT在活体肾移植供体术前评价中的价值。方法:174例供肾者接受了MSCT多期扫描,所有图像由2位放射科医师进行分析和评价,记录肾血管和集尿系统的解剖、变异以及其他可能影响肾移植的因素。与术中结果对照,计算MSCT对肾移植供体术前评价的敏感度和特异度。结果:174例供肾者共检出348个肾,61例供肾者可见副肾动脉,26例供肾者存在肾动脉提前分叉,5例供肾者存在肾盂输尿管重复畸形,29例供肾者存在肾静脉畸形,包括副肾静脉、环腹主动脉左肾静脉、主动脉后左肾静脉。47例供肾者进行供肾切除,其中36例行左肾切除术,11例行右肾切除术。MSCT在诊断肾血管和集尿系统解剖方面,敏感度和特异度均为100%。结论:MSCT可准确显示供肾血管、尿路和肾实质的结构,在活体肾移植术前评估中有重要作用。

Objective：To explore the value of multidetector computed tomography in the preoperative assessment of living kidney donors in kidney transplantation. Methods： Multiphase CT scan was performed in 174 living kidney donors. Two radiologists analyzed and evaluated all the images, recorded renal artery and vein and urinary tract anatomy, and other factors affecting kidney transplantation. Sensitivity and specificity were calculated for multidetector CT finding in preopera- tive assessment of living kidney donors compared with intraoperative findings. Results Three hundred and forty eight kid- neys were found in the 174 living donors. Sixty-one patients had accessory renal arteries,26 patients had early branching re- nal arteries, 5 patients had duplicated renal pelvis and ureter and 29 patients had renal vein abnormalities including accessory renal veins, circumaortic left renal vein and retroaortic left renal vein. Among the 47 living donors undergoing renal excision, 36 donors accepted left renal excision and 11 accepted right renal excision. Sensitivity and specificity were 100% in showing the renal vascular and urinary tract anatomy by multidetector CT. Conclusion： Multidetector computed tomography is a relia- ble method to evaluate renal vessels, urinary tract and renal parenchyma, and plays an important role in living donor renal transplantation.