Gluecker Thomas M, Mayr Michael, Schwarz Jochen, Bilecen Deniz, Voegele Thomas, Steiger Juerg, Bachmann Alexander, Bongartz Georg
Department of Diagnostic Radiology, University Hospital Basel, Basel, Switzerland.
Transplantation. 2008 Nov 15;86(9):1249-56. doi: 10.1097/TP.0b013e3181890810.
The aim of the study was to prospectively compare the diagnostic performance of CT angiography (CTA) with MR angiography (MRA) in the preoperative assessment of living renal donors.
Forty-eight potential living renal donors (mean 51 years, 29-67 years) underwent multislice CTA and gadolinium-enhanced MRA. Six potential donors were excluded. Forty-two donors underwent minimal invasive retroperitoneoscopic nephrectomy (left 36, right 6) and their datasets available for analysis independently performed by two blinded radiologists. The surgical status served as gold standard.
In 42 donors (84 kidneys), CTA identified 63 kidneys with 1 artery (MRI 61), 19 with 2 arteries (MRI 20), one with three arteries (MRI 2), and one with four arteries (MRI 1). Considering only the side with the surgical status available for verification, both CT and MRI correctly characterized 35 of 36 donors with a single renal artery and five of six with one supernumerary artery. Two false positives were two arteries suggested as supernumerary both in CT and MRI not confirmed during surgery. CTA and MRA both correctly identified three accessory renal veins in two donors.
CTA and MRA had the same accuracy for characterization of renal vasculature in the preoperative assessment of living renal donors.
本研究的目的是前瞻性比较CT血管造影(CTA)与磁共振血管造影(MRA)在活体肾供体术前评估中的诊断性能。
48名潜在的活体肾供体(平均51岁,29 - 67岁)接受了多层CTA和钆增强MRA检查。6名潜在供体被排除。42名供体接受了微创后腹腔镜肾切除术(左侧36例,右侧6例),其数据集由两名不知情的放射科医生独立进行分析。手术情况作为金标准。
在42名供体(84个肾脏)中,CTA识别出63个单支动脉肾脏(MRI识别出61个)、19个双支动脉肾脏(MRI识别出20个)、1个三支动脉肾脏(MRI识别出2个)和1个四支动脉肾脏(MRI识别出1个)。仅考虑有手术情况可供验证的一侧,CT和MRI均正确识别出36名单支肾动脉供体中的35名以及6名有一支额外动脉供体中的5名。两个假阳性是指CT和MRI均提示为额外动脉但手术中未得到证实的两支动脉。CTA和MRA均正确识别出两名供体中的三条副肾静脉。
在活体肾供体术前评估中,CTA和MRA在肾血管系统特征描述方面具有相同的准确性。