Department of Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan.
Department of Radiology, Okayama University Hospital, Okayama, Japan.
Jpn J Radiol. 2024 Jun;42(6):648-655. doi: 10.1007/s11604-024-01538-y. Epub 2024 Feb 23.
To retrospectively evaluate the depiction rate of feeding arteries in biopsy-proven clear cell renal cell carcinoma (CCRCC) on four-dimensional computed tomography angiography (4D-CTA) images.
This study included 22 patients with 22 CCRCC and 30 feeding arteries treated with transcatheter renal artery embolization. The depiction rate of the feeding arteries on preprocedural 4D-CTA was evaluated. Images were acquired by 320-row multi-detector computed tomography (CT) 15‒36 s after starting to inject a contrast agent (600 mg/kg iodine) intravenously into patients at 2.1 s intervals (11 phases). Two board-certified radiologists retrospectively assessed the feeder depiction rate in all 11 phases with reference to the procedural images as the gold standard. Discrepancies were resolved by consultation with a third radiologist.
Among the feeders, 11 (36.7%) were segmental or lobar, and 19 (63.3%) were interlobar or arcuate arteries. The feeder depiction rate was the highest (25 [83.3%] of 30) in the 5th phase (delay, 23.4 s) where the gap in contrast enhancement between the renal artery and cortex was the largest. This was followed by the 6th (23 [76.7%] of 30), 4th (22 [73.3%] of 30]), and 7th (21 [70.0%] of 30) phases. The overall rate of depicting feeding arteries in the 11 phases of 4D-CTA was 28 (93.3%) of 30.
The depiction rate of CCRCC feeding arteries including lobar or smaller artery branches by 4D-CTA was favorable. The feeding arteries were optimally visualized during the phase with the largest contrast gap between the renal artery and cortex.
回顾性评估经活检证实的透明细胞肾细胞癌(CCRCC)在四维 CT 血管造影(4D-CTA)图像上的供血动脉显影率。
本研究纳入 22 例 22 个 CCRCC 患者和 30 个供血动脉,这些患者均接受经导管肾动脉栓塞治疗。评估了术前 4D-CTA 上供血动脉的显影率。使用 320 排多探测器 CT 在患者静脉注射对比剂(600mg/kg 碘)后 15-36s 以 2.1s 的间隔(11 期)进行图像采集。两名具有董事会认证的放射科医生参考手术图像作为金标准,回顾性地评估了所有 11 期的供血动脉显影率。有分歧时,由第三位放射科医生协商解决。
在供血动脉中,11 个(36.7%)为节段或叶状动脉,19 个(63.3%)为叶间或弓形动脉。在对比度增强肾动脉和皮质之间差距最大的第 5 期(延迟 23.4s),供血动脉的显影率最高(30 个中的 25 个[83.3%])。其次是第 6 期(30 个中的 23 个[76.7%])、第 4 期(30 个中的 22 个[73.3%])和第 7 期(30 个中的 21 个[70.0%])。4D-CTA 的 11 期总体显示供血动脉的比率为 30 个中的 28 个(93.3%)。
4D-CTA 对 CCRCC 供血动脉包括叶状或更小的动脉分支的显示率良好。在肾动脉和皮质之间对比度差距最大的阶段,最佳地显示了供血动脉。