Kim Jeong Kon, Kim Jin Hyoung, Bae Sang-Jin, Cho Kyoung-Sik
Department of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, 388-1 Poongnap-dong, Songpa-gu, Seoul 138-736, South Korea.
AJR Am J Roentgenol. 2004 Aug;183(2):471-7. doi: 10.2214/ajr.183.2.1830471.
We sought to compare various reconstruction methods for CT angiographic images in evaluating living renal donors.
In 76 patients who underwent donor nephrectomy, vascular phase CT data were obtained using an MDCT scanner (detector array, 1.25 mm x 4; beam pitch, 1.5). Two radiologists independently reconstructed CT angiographic images using thick-slab volume rendering, thick-slab maximum intensity projection (MIP), sliding thin-slab volume rendering, and sliding thin-slab MIP. The radiologists counted the number of renal arteries, early branching arteries, and renal veins. We compared the accuracy rates for the detection of vessels achieved with the four types of reconstructed images, using the surgical findings as the gold standard. Agreement between the two observers and between the surgical and CT angiographic findings was evaluated.
The sensitivity for detecting the supernumerary artery was significantly greater with sliding thin-slab volume rendering and sliding thin-slab MIP (97%) than with thick-slab volume rendering (59%) (p = 0.039). No significant difference between the other comparison pairs of reconstruction methods was found. The interobserver agreement for detecting supernumerary and early branching arteries with sliding thin-slab volume rendering and MIP was excellent (kappa = 0.820-0.859) and good for renal veins (kappa = 0.698-0.724), whereas the agreement of thick-slab volume rendering and MIP was good for arteries (kappa = 0.706-0.791) and moderate for veins (kappa = 0.443-0.579). The agreement between CT angiographic reconstructed images and surgical findings for detection of vessels was better with sliding thin-slab volume rendering and MIP (kappa = 0.793-1.000) than in thick-slab volume rendering and MIP (kappa = 0.306-0.613).
For CT angiographic evaluation of living renal donors, sliding thin-slab reconstruction is superior to thick-slab reconstruction.
我们试图比较CT血管造影图像的各种重建方法在评估活体肾供体方面的效果。
对76例行供肾切除术的患者，使用MDCT扫描仪（探测器阵列，1.25 mm×4；螺距，1.5）获取血管期CT数据。两名放射科医生分别使用厚层容积再现、厚层最大密度投影（MIP）、薄层容积再现和薄层MIP重建CT血管造影图像。放射科医生计数肾动脉、早期分支动脉和肾静脉的数量。以手术结果为金标准，比较四种重建图像检测血管的准确率。评估两名观察者之间以及手术和CT血管造影结果之间的一致性。
薄层容积再现和薄层MIP检测多支动脉的敏感度（97%）显著高于厚层容积再现（59%）（p = 0.039）。其他重建方法比较对之间未发现显著差异。薄层容积再现和MIP检测多支和早期分支动脉的观察者间一致性极佳（kappa = 0.820 - 0.859），对肾静脉的一致性良好（kappa = 0.698 - 0.724），而厚层容积再现和MIP对动脉的一致性良好（kappa = 0.706 - 0.791），对静脉的一致性中等（kappa = 0.443 - 0.579）。薄层容积再现和MIP检测血管的CT血管造影重建图像与手术结果之间的一致性（kappa = 0.793 - 1.000）优于厚层容积再现和MIP（kappa = 0.306 - 0.613）。
对于活体肾供体的CT血管造影评估，薄层重建优于厚层重建。
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