MSCT肾血管成像在肾肿瘤术前评价中的临床应用价值

The clinical value of renal angiography with multi-slice spiral CT in the evaluation of renal tumor before operation

目的:评价多层螺旋CT(MSCT)肾血管成像在肾肿瘤术前评估中的临床应用价值。方法:回顾性分析经手术及病理证实的50例肾肿瘤患者。所有患者均行64层螺旋CT肾血管成像检查,应用容积再现(VR)、最大密度投影(MIP)、多平面重建(MPR)等后处理技术进行肾血管重建,评价肾肿瘤与肾门血管、集合系统的关系,肿瘤血供及患肾血管变异情况,并与手术结果对照。结果:50例肾肿瘤患者均获得满意的轴位原始图像,应用VR、MIP及MPR等后处理技术,显示肾肿瘤位置、范围及与肾门血管、集合系统关系、肿瘤血供及肾静脉变异与术中所见一致。3例肾动脉变异与手术结果不符:1例左侧副肾动脉纤细,供应左肾上极,术中仅见1支左肾动脉;1例左侧4支副肾动脉,术中仅发现3支副肾动脉;1例左肾动脉提前分支,术中误认为左侧2支肾动脉。结论:MSCT肾血管成像可直观、准确地显示肿瘤位置、范围及与肾门血管、集合系统关系、肿瘤血供及患肾血管变异情况,对指导术者制定手术方案及预防术中并发症有重要的临床意义。

Objective：To explore the clinical value of multi -slice spiral CT （MSCT）of renal angiography in re-nal tumor preoperation.Methods：Fifty patients with renal tumor confirmed by operation and pathology were analyzed retrospectively and underwent imaging of 64 slice spiral CT renal angiography,using volume rendering （VR）,maxi-mum intensity projection （MIP）,multiple planar reconstruction （MPR）and other processing techniques for renal vascular reconstruction,evaluating the relationship between renal tumor and renal hilum,collection system,blood sup-ply of the tumor and renal vascular variation,and comparing the results with operation and pathology.Results：All 50 cases of renal tumor patients were satisfied with the original axial images.Application of VR,MIP,MPR and other post-processing techniques.MSCT renal angiography showed the relations between renal tumor location,scope and renal hilum vascular,collection system,blood supply of the tumor and renal vein variation,consistent with the intraoperative findings.3 cases of renal artery variation and operation results do not match.Left accessory renal artery was slender in a case,supplying the upper pole of the left kidney,not seen in the operation.A case with 4 left accessory renal arteries was found only 3 branches in the operation.Left renal artery was branched in advance in a case,mistaken 2 left bran-ches of renal artery in the operation.Conclusion：MSCT renal angiography can visually,accurately show the location and scope of the tumor,and the relations with renal hilum vascular and renal vascular variation.There was important clinical significance in the guidance of making operation scheme and the prevention of complications of operation.