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目的:评价16层螺旋CT三维重建在活体供肾血管、肾实质、泌尿系统评估中的实际应用价值。方法:回顾2004年以来41例活体肾移植供体临床资料,术前均行16层螺旋CT扫描,采集肾动脉期、静脉期以及排泄期的影像数据,采用MIP、VR、MPR和CRP等三维图像后处理技术,评估供体肾动脉、肾静脉、泌尿集合系统和肾实质情况,与术中所见相对照。结果:41例供肾动脉显示,34例双肾单支动脉供血,其中2例左肾动脉、3例右肾动脉分支较早;4例右肾见一支副肾动脉,3例左肾见一支副肾动脉;术中证实有1例右副肾动脉,1例左肾动脉早期分支未能在影像中显示清楚,准确率95.1%。41例供肾静脉显示,37例双肾静脉为单支,4例右侧双支肾静脉;术中证实5例右侧双支肾静脉未能在影像中显示,准确率87.8%;泌尿集合系统显影满意,1例左侧双肾盂双输尿管畸形。结论:16层螺旋CT三维重建能准确显示供体肾脏血管、泌尿集合系统、肾实质解剖及可能的病理情况,给临床肾移植术前评估提供有价值的帮助,可作为供体术前检查的首选方法。
Objective: To evaluate the practical value of three-dimensional reconstruction of 16-slice spiral CT in the evaluation of living donor’s blood vessels, renal parenchyma and urinary system. Methods: The clinical data of 41 cases of living donor kidney transplant recipients since 2004 were retrospectively analyzed. Sixteen-slice spiral CT scans were performed preoperatively to collect the image data of renal artery, venous phase and excretory phase. MIP, VR, MPR and CRP Image postprocessing techniques to assess donor renal arteries, renal veins, urinary collecting system, and renal parenchyma were compared with those seen intraoperatively. Results: 41 cases of renal artery showed that 34 cases of single renal artery were supplied with renal artery, 2 cases of left renal artery and 3 cases of right renal artery earlier. 4 cases of right kidney showed one renal artery, 3 cases of left kidney One accessory renal artery. One right accessory renal artery was confirmed during operation. One branch of the left renal artery failed to show clearly in the image with an accuracy rate of 95.1%. 41 cases of renal vein showed that 37 cases of double renal vein as a single, 4 cases of right double renal branch vein; 5 cases of right double renal branch vein was not demonstrated in the image, the accuracy rate of 87.8%; urinary collection System development satisfaction, 1 case of double renal duodenal ureter deformity. Conclusion: Three-dimensional reconstruction of 16-slice spiral CT can accurately display the donor’s blood vessels and urinary collecting system, renal parenchymal anatomy and possible pathological conditions, and provide valuable help for clinical renal transplantation preoperative evaluation. Preferred method.