Alam A, Chander B N, Joshi D P
Classified Specialist (Radiodiagnosis & Imaging), Command Hospital (Air Force), Bangalore - 560 007.
Senior Advisor (Radiodiagnosis & Imaging), Command Hospital (Air Force), Bangalore - 560 007.
Med J Armed Forces India. 2003 Jul;59(3):205-8. doi: 10.1016/S0377-1237(03)80007-2. Epub 2011 Jul 21.
A total of 30 potential renal donors aged between 35 and 50 years were subjected to pre-operative 3-Dimensional Spiral Computerised Tomography (CT) angiography with the aim to assess its efficacy in the evaluation of renal vasculature. The investigations were carried out on a Philips Tomoscan AV Spiral CT scanner. Scan parameters included a collimation of 3 mm and table speed of 4 mm/sec. A total of 120 ml of non-ionic contrast was injected at a rate of 4 ml per second using a power injector. The axial images obtained were reconstructed at 2mm intervals and 3-D reconstruction was done using Surface Shaded Display (SSD) and Maximum Intensity Projection (MIP) protocols. CT angiography and its correlation with per-operative findings revealed 97 to 100% sensitivity and specificity in identifying the main and accessory renal arteries and veins. The angiogram also excluded the presence of pathologies like polycystic kidney, horse shoe kidney with a thick isthmus and occult renal cell carcinoma that would prevent the patient from being a donor. 3-D spiral CT angiography allows the radiologist to provide the transplant surgeon with precise pre-operative anatomy of the renal vasculature thus reducing the risks and complications associated with the harvesting procedure and increasing the chances of a successful outcome. Thus it is a fast, accurate, inexpensive and minimally invasive procedure that is becoming the modality of choice for the pre-operative evaluation of potential renal transplant donors.
共有30名年龄在35至50岁之间的潜在肾供体接受了术前三维螺旋计算机断层扫描（CT）血管造影，目的是评估其在评估肾血管系统方面的功效。研究在飞利浦Tomoscan AV螺旋CT扫描仪上进行。扫描参数包括3毫米的准直和4毫米/秒的床速。使用高压注射器以每秒4毫升的速率注入总共120毫升的非离子型造影剂。获得的轴向图像以2毫米的间隔重建，并使用表面阴影显示（SSD）和最大密度投影（MIP）协议进行三维重建。CT血管造影及其与术中发现的相关性显示，在识别主要和副肾动脉及静脉方面，敏感性和特异性为97%至100%。血管造影还排除了多囊肾、峡部增厚的马蹄肾和隐匿性肾细胞癌等会使患者无法成为供体的病变。三维螺旋CT血管造影使放射科医生能够为移植外科医生提供精确的术前肾血管解剖结构，从而降低与摘取手术相关的风险和并发症，并增加成功的机会。因此，它是一种快速、准确、廉价且微创的检查方法，正成为潜在肾移植供体术前评估的首选方式。
