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四维度计算机断层血管摄影术对肾细胞癌供养动脉的描绘率。

Depiction rate of feeding arteries of renal cell carcinoma on four-dimensional computed tomography angiography.

机构信息

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.

出版信息

Jpn J Radiol. 2024 Jun;42(6):648-655. doi: 10.1007/s11604-024-01538-y. Epub 2024 Feb 23.

Abstract

PURPOSE

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.

MATERIALS AND METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

目的

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。

材料与方法

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。

结果

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%)。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ec9/11139722/ea3551d8e5fe/11604_2024_1538_Fig1_HTML.jpg

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