Department of Urology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Radiology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
Eur Radiol. 2020 Feb;30(2):798-805. doi: 10.1007/s00330-019-06423-1. Epub 2019 Aug 30.
To assess image quality and diagnostic accuracy of low-dose computed tomography (CT) angiography using adaptive statistical iterative reconstruction V (ASiR-V) for evaluating the anatomy of renal vasculature in potential living renal donors.
Eighty of 100 potential living renal donors were prospectively enrolled and underwent multiphase CT angiography (e.g., unenhanced, arterial, and venous phases) to evaluate the kidney for donation. Either low-dose using ASiR-V or standard protocol was randomly applied. Image quality was analyzed qualitatively and quantitatively with contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR). Renal artery and vein number, early branching vessel from renal arteries, and drainage of left-sided ascending lumbar vein to left renal vein were assessed. Reference standard for renal vasculature was surgical confirmation.
Size-specific dose estimate of low-dose CT angiography (9.5 ± 0.8 mGy) was significantly lower than standard CT angiography (22.7 ± 4.1 mGy) (p < 0.001). Thus, radiation dose was reduced by 58.2% with low-dose CT. Both CNR and SNR of low-dose CT were significantly higher than those of standard CT (p < 0.001). Between the two CT methods, image quality was similar qualitatively (p > 0.05). Of 80 participants, 44 (55.0%) underwent nephrectomy. Both CT methods accurately predicted the anatomy of renal vasculature (standard CT, 100% for all variables; low-dose CT, 96.6% for renal vessel number or early branching vessel and 85.7% for drainage of left-sided ascending lumbar vein to left renal vein; p > 0.05 for all comparisons).
Low-dose CT angiography using ASiR-V is useful to evaluate renal vasculature for potential living renal donors.
• In this prospective study, adaptive statistical iterative reconstruction V (ASiR-V) allowed 58.2% dose reduction while maintaining diagnostic image quality for renal vessels. • As compared with the standard protocol, the dose with ASiR-V was significantly lower (9.5 ± 0.8 mGy) than with standard computed tomography (CT) angiography (22.7 ± 4.1 mGy). • Low-dose CT using ASiR-V is useful for living donor evaluation before nephrectomy.
评估自适应统计迭代重建 V（ASiR-V）在低剂量 CT 血管造影中的应用，以评估潜在活体供肾者的肾血管解剖结构。
前瞻性纳入 100 名潜在活体供肾者中的 80 名，并进行多期 CT 血管造影（如平扫、动脉期和静脉期）以评估供肾情况。随机应用低剂量 ASiR-V 或标准方案。通过对比噪声比（CNR）和信噪比（SNR）对图像质量进行定性和定量分析。评估肾动脉和静脉数量、肾动脉早期分支血管和左侧升主动脉静脉向左侧肾静脉的引流情况。肾血管的参考标准为手术确认。
低剂量 CT 血管造影（9.5±0.8 mGy）的剂量比标准 CT 血管造影（22.7±4.1 mGy）明显降低（p<0.001）。因此，低剂量 CT 可将辐射剂量降低 58.2%。低剂量 CT 的 CNR 和 SNR 均明显高于标准 CT（p<0.001）。两种 CT 方法的图像质量在定性上相似（p>0.05）。80 名参与者中，44 名（55.0%）行肾切除术。两种 CT 方法均能准确预测肾血管解剖结构（标准 CT 血管造影术，所有变量均为 100%；低剂量 CT 血管造影术，肾血管数量或早期分支血管为 96.6%，左侧升主动脉静脉向左侧肾静脉引流为 85.7%；所有比较均为 p>0.05）。
ASiR-V 低剂量 CT 血管造影术有助于评估潜在活体供肾者的肾血管。
在这项前瞻性研究中，自适应统计迭代重建 V（ASiR-V）允许将剂量降低 58.2%，同时保持肾血管的诊断图像质量。
与标准方案相比，ASiR-V 组的剂量（9.5±0.8 mGy）明显低于标准 CT 血管造影术（22.7±4.1 mGy）。
低剂量 ASiR-V CT 血管造影术在活体供肾者肾切除术前评估中很有用。
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