前瞻性肾供体腹部计算机断层血管造影术中偶然发现的发生率。

Prevalence of incidental findings on abdominal computed tomography angiograms on prospective renal donors.

作者信息

Tan Nelly, Charoensak Aphinya, Ajwichai Khobkhoon, Gritsch Hans Albin, Danovitch Gabriel, Schulam Peter, Lu David S K, Margolis Daniel J, Raman Steven S

机构信息

1 Department of Radiology, David Geffen School of Medicine at University of California, Los Angeles CA. 2 Department of Radiology, Siriraj Hospital, Mahidol University, Bangkok, Thailand. 3 Department of Urology, David Geffen School of Medicine at University of California, Los Angeles, CA. 4 Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA. 5 Department of Urology, Yale-New Haven Hospital, New Haven, CT.

出版信息

Transplantation. 2015 Jun;99(6):1203-7. doi: 10.1097/TP.0000000000000486.

DOI:10.1097/TP.0000000000000486

PMID:25651306

Abstract

OBJECTIVE

To evaluate the prevalence of incidental findings on preoperative abdominal computed tomography angiography-computed tomography urography in asymptomatic prospective renal donors.

METHODS

A Health Insurance Portability and Accountability Act (HIPAA)-compliant, Institutional Review Board (IRB)-approved retrospective study of 1,597 subjects undergoing renal transplant evaluation from June 1, 2006, to March 31, 2011, was performed. Candidates underwent multiphasic multidetector computed tomography angiography-computed tomography urography for presurgical evaluation of renal vascular and parenchymal anatomy. All scans were reviewed by one of three fellowship-trained abdominal radiologists. The diagnoses were made on the basis of computed tomography characteristics of each lesion, and pathology confirmation was available for seven patients. We calculated the prevalence of each incidental finding, performed Fisher exact test or chi-square test for categorical variables between the cohort that did and did not undergo donor nephrectomy, and performed simple linear logistic regression analysis of incidental findings which predicted renal donation.

RESULTS

Of the 1,597 potential donors, 58.4% were female, and the mean age was 42.6 years (range, 18-74). One thousand one hundred ninety-five (74.9%) had a total of 2,105 incidental findings. Based on American College of Radiology Incidental Findings Committee White Paper on Managing Incidental Findings on Abdominal Computed Tomography, 17.3% had incidentalomas and 1.1% required follow-up. Majority of the incidental findings (16 of 17) were in patients who did not undergo renal donation. The prevalence of pathologically proven malignancy was 0.1% (3 of 1,597).

CONCLUSION

Preoperative computed tomography angiography-computed tomography urography not only identifies vascular anatomy but may also help detect clinically significant unanticipated findings in an otherwise healthy population.

摘要

目的

评估无症状的潜在肾供体术前腹部计算机断层血管造影-计算机断层尿路造影中偶然发现的病变的发生率。

方法

进行了一项符合健康保险流通与责任法案（HIPAA）且经机构审查委员会（IRB）批准的回顾性研究，研究对象为2006年6月1日至2011年3月31日期间接受肾移植评估的1597名受试者。候选者接受多期多层螺旋计算机断层血管造影-计算机断层尿路造影，以对肾血管和实质解剖结构进行术前评估。所有扫描图像均由三名经过专科培训的腹部放射科医生之一进行审查。根据每个病变的计算机断层扫描特征做出诊断，7例患者有病理证实。我们计算了每个偶然发现病变的发生率，对接受和未接受供肾切除术的队列之间的分类变量进行Fisher精确检验或卡方检验，并对预测肾捐赠的偶然发现病变进行简单线性逻辑回归分析。

结果

在1597名潜在供体中，58.4%为女性，平均年龄为42.6岁（范围18 - 74岁）。1195名（74.9%）共有2105个偶然发现病变。根据美国放射学会偶然发现病变委员会关于腹部计算机断层扫描中偶然发现病变管理的白皮书，17.3%有偶然瘤，1.1%需要随访。大多数偶然发现病变（17例中的16例）出现在未进行肾捐赠的患者中。病理证实的恶性肿瘤发生率为0.1%（1597例中的3例）。