Bhatti Aftab A, Chugtai Aamir, Haslam Philip, Talbot David, Rix David A, Soomro Naeem A
Department of Urology, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK.
BJU Int. 2005 Nov;96(7):1105-8. doi: 10.1111/j.1464-410X.2005.05809.x.
To prospectively compare the accuracy of multislice spiral computed tomographic angiography (CTA) and magnetic resonance angiography (MRA) in evaluating the renal vascular anatomy in potential living renal donors.
Thirty-one donors underwent multislice spiral CTA and gadolinium-enhanced MRA. In addition to axial images, multiplanar reconstruction and maximum intensity projections were used to display the renal vascular anatomy. Twenty-four donors had a left laparoscopic donor nephrectomy (LDN), whereas seven had right open donor nephrectomy (ODN); LDN was only considered if the renal vascular anatomy was favourable on the left. CTA and MRA images were analysed by two radiologists independently. The radiological and surgical findings were correlated after the surgery.
CTA showed 33 arteries and 32 veins (100% sensitivity) whereas MRA showed 32 arteries and 31 veins (97% sensitivity). CTA detected all five accessory renal arteries whereas MRA only detected one. CTA also identified all three accessory renal veins whereas MRA identified two. CTA had a sensitivity of 97% and 47% for left lumbar and left gonadal veins, whereas MRA had a sensitivity of 74% and 46%, respectively.
Multislice spiral CTA with three-dimensional reconstruction was more accurate than MRA for both renal arterial and venous anatomy.
前瞻性比较多层螺旋计算机断层血管造影(CTA)和磁共振血管造影(MRA)在评估潜在活体肾供体肾血管解剖结构方面的准确性。
31名供体接受了多层螺旋CTA和钆增强MRA检查。除轴位图像外,还使用多平面重建和最大密度投影来显示肾血管解剖结构。24名供体进行了左侧腹腔镜供肾切除术(LDN),而7名进行了右侧开放供肾切除术(ODN);仅当左侧肾血管解剖结构有利时才考虑LDN。CTA和MRA图像由两名放射科医生独立分析。术后将影像学和手术结果进行关联。
CTA显示33条动脉和32条静脉(敏感性100%),而MRA显示32条动脉和31条静脉(敏感性97%)。CTA检测到所有5条副肾动脉,而MRA仅检测到1条。CTA还识别出所有3条副肾静脉,而MRA识别出2条。CTA对左腰静脉和左性腺静脉的敏感性分别为97%和47%,而MRA的敏感性分别为74%和46%。
对于肾动脉和静脉解剖结构,具有三维重建的多层螺旋CTA比MRA更准确。