3特斯拉高空间分辨率磁共振血管造影术对潜在活体亲属肾供体的术前评估：与术中发现的比较

Preoperative evaluation of potential living related kidney donors with high-spatial-resolution magnetic resonance (MR) angiography at 3 Tesla: comparison with intraoperative findings.

作者信息

Kramer Ulrich, Thiel Christian, Seeger Achim, Fenchel Michael, Laub Gerhard, Finn Paul J, Steurer Wolfgang, Claussen Claus D, Miller Stephan

机构信息

Department of Diagnostic Radiology, University of Tuebingen, Tuebingen, Germany.

出版信息

Invest Radiol. 2007 Nov;42(11):747-55. doi: 10.1097/RLI.0b013e31812dfb11.

DOI:10.1097/RLI.0b013e31812dfb11

PMID:18030197

Abstract

PURPOSE

The purpose of this prospective study was to determine the feasibility and accuracy of high-spatial-resolution MR imaging at 3 Tesla (T) in the preoperative evaluation of potential living related kidney donors.

MATERIALS AND METHODS

Eighteen potential donors (8 men, 10 women; mean age, 50.1 +/- 14.2 years) for renal transplantation were evaluated with 3 T MR imaging. A high-spatial-resolution 3-dimensional (3D) gradient-echo MR angiography (repetition time/echo time, 3.0/1.14 ms; flip, 19-23 degrees; matrix, 512; slice thickness, 1.0 mm) using parallel acquisition technique (GRAPPA) with an acceleration factor of 3 was performed on a whole body scanner. Images were evaluated in a prospective and blinded fashion by 2 MR radiologists. The number of renal arteries, presence of early branches (defined as a branch arising within 2 cm of the main renal ostium), and renal artery stenosis were analyzed. The renal parenchyma, collecting system and ureters, were evaluated on the MR urograms. Interpretation of MR images were compared with surgical findings.

RESULTS

Based on MR angiography data sets, a total of 36 main and 9 accessory renal arteries was found. There were 5 renal arteries presenting an early branching (<or=2 cm). The correct venous anatomy was identified in 13 of 14 patients (93%), including a single left renal vein anterior to the aorta (n = 3), retroaortic left renal vein (n = 2), and single right renal vein (n = 9). A single collecting system in all harvested kidneys was identified correctly with MR imaging. Overall, the sensitivity and positive predictive value of MRI in correctly determining the vascular and parenchymal anatomy in the harvested kidney was 85% and 93%, respectively.

CONCLUSIONS

High-spatial-resolution contrast-enhanced MR angiography at 3 T can predict successful donor nephrectomy in potential living related kidney donors.

摘要

目的

本前瞻性研究的目的是确定3特斯拉（T）高空间分辨率磁共振成像（MR成像）在术前评估潜在活体亲属肾供体中的可行性和准确性。

材料与方法

对18名肾移植潜在供体（8名男性，10名女性；平均年龄50.1±14.2岁）进行3T MR成像评估。在全身扫描仪上采用并行采集技术（GRAPPA），加速因子为3，进行高空间分辨率三维（3D）梯度回波磁共振血管造影（重复时间/回波时间，3.0/1.14 ms；翻转角，19 - 23度；矩阵，512；层厚，1.0 mm）。由2名MR放射科医生以前瞻性和盲法方式评估图像。分析肾动脉数量、早期分支的存在情况（定义为在主肾门2 cm内出现的分支）以及肾动脉狭窄情况。在MR尿路造影上评估肾实质、集合系统和输尿管。将MR图像的解读与手术结果进行比较。

结果

基于磁共振血管造影数据集，共发现36条主肾动脉和9条副肾动脉。有5条肾动脉出现早期分支（≤2 cm）。14例患者中有13例（93%）正确识别了静脉解剖结构，包括主动脉前单一左肾静脉（n = 3）、主动脉后左肾静脉（n = 2）和单一右肾静脉（n = 9）。MR成像正确识别了所有摘取肾脏中的单一集合系统。总体而言，MRI在正确确定摘取肾脏的血管和实质解剖结构方面的敏感性和阳性预测值分别为85%和93%。