Rouvière O, Lyonnet D, Berger P, Pangaud C, Gelet A, Martin X
Department of Radiology, Edouard Herriot Hospital, Lyon, France.
Radiology. 1999 Dec;213(3):668-73. doi: 10.1148/radiology.213.3.r99dc22668.
To evaluate helical computed tomography (CT) in the preoperative assessment of crossing arteries in kidneys with ureteropelvic junction (UPJ) obstruction and to compare the results with those obtained by means of angiography.
Forty-one consecutive patients with symptomatic UPJ obstruction in 42 obstructed kidneys underwent renal helical CT and renal intraarterial digital subtraction angiography (DSA; flush aortography and bilateral selective renal injections). The helical CT and DSA images were interpreted in a blinded manner by two readers, and the results were compared.
DSA showed 126 renal arteries in the 41 patients; 56% of patients had supernumerary renal arteries. Helical CT depicted 121 (96%) of these 126 renal arteries prospectively. Retrospectively, 124 (98%) renal arteries were visible on CT images. Twelve (29%) of the 42 kidneys with UPJ obstruction had identifiable arteries crossing the UPJ on DSA images. If DSA is used as the standard of reference, CT angiography was 100% sensitive and 96.6% specific for depicting these crossing arteries.
Renal helical CT seems suitable to replace intraarterial DSA in the preoperative assessment of crossing arteries in kidneys with UPJ obstruction.
评估螺旋计算机断层扫描（CT）在输尿管肾盂连接部（UPJ）梗阻的肾脏中对交叉动脉的术前评估价值，并将结果与血管造影所得结果进行比较。
42例梗阻性肾脏出现症状性UPJ梗阻的41例连续患者接受了肾脏螺旋CT和肾动脉内数字减影血管造影（DSA；腹主动脉造影和双侧选择性肾动脉注射）。两名阅片者以盲法解读螺旋CT和DSA图像，并比较结果。
DSA显示41例患者中有126条肾动脉；56%的患者有额外肾动脉。螺旋CT前瞻性地显示了这126条肾动脉中的121条（96%）。回顾性分析，CT图像上可见124条（98%）肾动脉。42例UPJ梗阻的肾脏中有12例（29%）在DSA图像上有可识别的动脉穿过UPJ。以DSA作为参考标准，CT血管造影对描绘这些交叉动脉的敏感性为100%，特异性为96.6%。
在术前评估UPJ梗阻的肾脏中的交叉动脉时，肾脏螺旋CT似乎适合替代动脉内DSA。
