Bazeed Mohamed Fayez, Fooshang Fawzy F, Ahmed Magdy Aly
Department of Diagnostic Radiology, Faculty of Medicine, Mansoura University, Egypt.
Acta Radiol. 2011 Oct 1;52(8):927-32. doi: 10.1258/ar.2011.110286. Epub 2011 Aug 26.
A routine, multiphase, computed tomography (CT) protocol is associated with high radiation exposure to potential kidney donors. To reduce radiation exposure, several authors have suggested a reduction in the number of phases.
To evaluate a low-radiation-dose, dual-phase protocol (i.e. a protocol with an unenhanced phase and combined vascular and excretory phase) for the preoperative evaluation of potential renal donors.
Sixty-five potential renal donors were divided into two groups. The first group was scanned with a routine quadric-phase protocol (non-contrast, arterial, venous, and delayed), and the second group was scanned with a triple-phase protocol (dual phase protocol + venous phase). In the second group, we replaced CT angiography with a routine abdominal CT technique. In addition to the evaluation of renal arteries, veins, and excretory systems, the radiation dose of the suggested protocol was compared to that of the routine quadric-phase protocol.
The suggested protocol was efficient in the evaluation of renal arteries, veins, and excretory systems in all studied potential renal donors. Renal arteries were well visualized in the combined vascular excretory phase using the routine abdominal CT technique; no significant difference was noted when these results were compared to those obtained from the CT angiography used in the quadric-phase protocol. The mean effective radiation dose of our suggested dual-phase protocol was only 34% of the dose resulting from the routine quadric-phase protocol.
Use of a low-radiation, dual-phase, CT protocol, which relied on both an unenhanced phase and a combined vascular and excretory phase, significantly reduced radiation dose. Furthermore, the proposed protocol provides adequate visualization of renal arteries and veins, and affords sufficient opacification of the urinary tract using improved acquisition triggering.
常规的多期计算机断层扫描（CT）方案会使潜在的肾脏供体受到高辐射暴露。为了减少辐射暴露，一些作者建议减少扫描期数。
评估一种低辐射剂量的双期方案（即包括平扫期以及血管期与排泄期联合扫描的方案）用于潜在肾脏供体的术前评估。
65名潜在肾脏供体被分为两组。第一组采用常规的四期方案（平扫、动脉期、静脉期和延迟期）进行扫描，第二组采用三期方案（双期方案 + 静脉期）进行扫描。在第二组中，我们用常规腹部CT技术替代了CT血管造影。除了评估肾动脉、静脉和排泄系统外，还将建议方案的辐射剂量与常规四期方案的辐射剂量进行了比较。
在所有研究的潜在肾脏供体中，建议方案在评估肾动脉、静脉和排泄系统方面是有效的。使用常规腹部CT技术在联合血管排泄期能很好地显示肾动脉；与四期方案中使用的CT血管造影所获得的结果相比，差异无统计学意义。我们建议的双期方案的平均有效辐射剂量仅为常规四期方案剂量的34%。
使用一种低辐射的双期CT方案，该方案依赖于平扫期以及血管期与排泄期联合扫描，可显著降低辐射剂量。此外，所提出的方案能充分显示肾动脉和静脉，并通过改进采集触发技术使尿路有足够的造影剂充盈。
