两种影像学方法对活体供肾的评估(1)
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【摘要】 目的 应用数字化减影肾血管造影术、多层螺旋CT对活体供肾进行评估,并对两种方法进行评价。方法 32例活体供肾者,术前4例采用DSA,、28例采用MSCT评价供肾情况,将两种影像的检查结果与术中所见对比。结果 4例行DSA检查,供者均为单枝动脉,其检查结果与手术所见相符;28例行MSCT检查,22例双肾均为单支动脉,3例两侧均有副肾动脉,2例为左肾双支动脉,1例为左侧主枝和副肾动脉,肾动脉早期分枝5例8枝;一例左肾静脉两支;发现双肾小囊肿9例;左侧输尿管上段扩张1例,左侧双肾盂、双输尿管1例,其双输尿管于骨盆沿并为一枝。术中所见与MSCT术前评估结果一致。术中发现左肾3枝副肾动脉CTA检查未能发现,但均细小。肾脏囊肿较多,但均为较小囊肿,多在0.1~0.3 cm左右,无临床意义。结论 术前采用DSA及MSCT进行供肾血管评价与手术所见一致;MSCT增强扫描能显示肾脏血管、肾实质形态、收集系统以及毗邻器官,同时创伤和并发症较DSA少,操作方便,可作为肾移植活体供者术前评估的首选方法。
【关键词】
活体供肾;多层螺旋CT;数字化减影血管造影术
Evaluation of two imaging methods for renal in living related donors
ZHANG Jie,CAI Xianan,FAN Rui,et al.Department of Urology,The center Hospital of Zhengzhou City,Zhengzhou Henan 450007,China
【Abstract】 Objective To evaluate the application of multislice spiral CT(MSCT)and digital subtraction angiography(DSA)for renal in living related donors.Methods 32 living donors were evaluated.DSA were used in 4 donors,and MSCT were used in 28 donors.The results were compared with that in surgery.Results DSA in 4 donors,all of them were displayed bilateral renal solitary artery and the findings agreed with the surgical results.MSCT in 28 donors,22 of them were displayed bilateral renal solitary artery of them,3 donors had renal accessory in both sides.2 donors had two renal arteries in left renals.1 donors had renal accessory in left sides.8 renal of 5 donors had prehilar branches.1 donors had two renal veins in left.Cortical cyst was found in 9 eases.1 donors had pyelectasis in left.1 donors had double pelvis and double ureter in left.The findings were confirmed in surgery.there were a few litter Cortical cyst and 3 litter renal accessory found in surgery.Conclusion The results of DSA and MSCT were corresponding to that in surgery.MSCT is not injury,convenience and economical.Morever,MSCTcan accurately assess living donor renal vasculature,the upper urinary tract,renal parenchyma and spatial interrelationships of the kidneys and adjacent organ.MSCT can be preferred in evaluating renal vascular in living donors ......
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