MSCT在肾动静脉畸形诊断中的应用价值

Value of multi-slice spiral CT in the diagnosis of renal arteriovenous malformation

目的:探讨MSCT对肾动静脉畸形(rAVM)的诊断价值。方法:回顾性分析经DSA或术后病理证实的14例rAVM患者的MSCT及其后处理影像资料,后处理技术包括多平面重组(MPR)、最大密度投影(MIP)、容积再现(VR)等。结果:14例患者中8例畸形较小,病灶位于皮髓质交界处,MSCT及其后处理图像均可清晰显示供血动脉及引流静脉;4例畸形较大,大部分畸形血管位于肾轮廓外,少部分畸形血管位于皮髓质内;2例合并肾下极血管平滑肌脂肪瘤,其供血动脉及引流静脉显示清晰。结论:MSCT及其后处理图像可清晰显示rAVM的畸形血管团,具有很高的诊断价值,可作为该病无创性筛查的首选方法。

Objective:To evaluate the value of multi-slice spiral CT(MSCT)in the diagnosis of renal arteriovenous malformation(rAVM).Methods:MSCT and its post-processing image data of 14 cases with rAVM confirmed by DSA or pathology after surgery were retrospectively analyzed.The post-processing techniques include multiplanar reformation(MPR),maximum intensity projection(MIP)and volume rendering(VR).Results:Eight of the 14 patients had small deformity and the lesions were located at corticomedullary junction,the supply arteries and drainage veins could be clearly shown on MSCT and the post-processing images.In 4 cases with large malformation,the majority of abnormal blood vessels were located outside the renal contour,and a small number of abnormal blood vessels were located within corticomedullary area.Two cases had rAVM in combination with renal angiomyolipoma at the lower pole of kidney,supply artery and drainage vein could be clearly revealed.Conclusion:The vascular malformation of rAVM could be clearly assessed on MSCT with image post-processing techniques,which provides a high diagnostic value,and thus can serve as the first chosen non-invasive screening modality.