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目的探讨16层螺旋CT血管造影在活体供肾动脉解剖学评估中的应用价值。方法36名亲属活体供肾者在肾切取前进行肾动脉16层螺旋CT血管造影及血管三维成像,血管三维成像方法包括容积再现技术(VR)、最大密度投影(MIP)、表面遮盖成像(SSD)、血管内镜技术(CTVE)、多平面重建(MPR)及曲面重建(CPR)。结果横断面CT及MPR显示所有供者的双肾大小、形态及位置均正常,肾实质密度正常,呈均匀强化。VR、MIP、CPR显示双肾动脉粗细、形态均正常;29例双肾均为单一肾动脉,2例双肾有2支肾动脉,2例左肾为2支肾动脉,3例右肾为2支肾动脉,上述结果均在术中得到证实。11例VR及MIP同时较好地显示双侧肾小盏、肾盂及输尿管上段。SSD均能很好显示肾动脉主干的起源、大小、形态及与周围的解剖关系。CTVE能较好显示腹主动脉、双肾动脉开口及肾动脉血管内腔。结论16层螺旋CT血管造影可作为活体肾移植术前了解供肾血管及形态的有效方法。
Objective To investigate the value of 16-slice spiral CT angiography in assessing the anatomy of living donor renal arteries. Methods Thirty-six male living donor donors underwent renal angiography and three-dimensional imaging of the renal artery before the excision of the kidney. The three-dimensional imaging of the blood vessels included volume rendering (VR), maximum density projection (MIP), surface occlusion imaging ), Endoscopic techniques (CTVE), multiplanar reconstruction (MPR) and surface reconstruction (CPR). Results The cross-sectional CT and MPR showed that the size, shape and location of all the kidneys of all the donors were normal. The density of renal parenchyma was normal and homogeneously enhanced. VR, MIP and CPR showed that the diameter and diameter of renal arteries were all normal. All the 29 kidneys were single renal arteries, 2 kidneys had 2 renal arteries, 2 left renal arteries were 2 renal arteries, 3 right kidney was 2 renal artery, the above results were confirmed during surgery. 11 cases of VR and MIP at the same time better display of bilateral renal calyx, renal pelvis and upper ureter. SSD can well show the origin of renal artery trunk, size, shape and the surrounding anatomy. CTVE can better display the abdominal aorta, renal artery opening and renal artery lumen. Conclusion 16-slice CT angiography can be used as an effective method for understanding the morphology and blood supply of renal vessels before living donor kidney transplantation.