Meyers S P, Talagala S L, Totterman S, Azodo M V, Kwok E, Shapiro L, Shapiro R, Pabico R C, Applegate G R
Department of Radiology, University of Rochester Medical Center, NY 14642.
AJR Am J Roentgenol. 1995 Jan;164(1):117-21. doi: 10.2214/ajr.164.1.7998523.
Donors routinely undergo preoperative conventional arteriography to evaluate the renal arteries before nephrectomy. The purpose of this study was to assess the capability of three-dimensional phase-contrast MR angiograms postprocessed with maximum-intensity-projection and surface-rendering techniques to show the renal arteries of potential donors.
Postprocessed three-dimensional phase-contrast MR angiograms of 17 patients were retrospectively reviewed by two experienced radiologists for the number and length of renal arteries visualized. Conventional arteriograms were used as the reference standard. Coronal maximum-intensity-projection and surface-rendered MR angiograms were also compared with each other with regard to the delineation of renal arteries from overlapping vessels.
MR angiograms showed all 34 single or dominant renal arteries but only eight of 10 accessory arteries seen on conventional arteriograms. One of the nonvisualized accessory arteries was located within the imaged volume, and the other one arose from the distal aorta beyond the imaged regions. Five of six arterial branches arising from the proximal 30-mm portions of the renal arteries were seen on MR angiograms. Postprocessing with either maximum-intensity projection or surface-rendering showed the same number of renal arteries, although surface rendering separated overlapping veins from the renal arteries better than the maximum-intensity-projection technique.
These results suggest that three-dimensional MR angiography is a reliable method of imaging single or dominant renal arteries, but not for showing all accessory renal arteries and small arterial branches. Surface rendering may provide specific advantages over maximum-intensity-projection in delineating renal arteries from overlapping vessels.
供体在肾切除术前行常规动脉造影以评估肾动脉情况。本研究旨在评估采用最大密度投影和表面渲染技术后处理的三维相位对比磁共振血管造影显示潜在供体肾动脉的能力。
由两名经验丰富的放射科医生对17例患者的后处理三维相位对比磁共振血管造影进行回顾性分析，观察显示的肾动脉数量及长度。以传统动脉造影作为参考标准。还比较了冠状面最大密度投影和表面渲染磁共振血管造影在区分重叠血管中的肾动脉方面的差异。
磁共振血管造影显示了所有34条单一或优势肾动脉，但在传统动脉造影中显示的10条副肾动脉中仅显示出8条。一条未显示的副肾动脉位于成像范围内，另一条起源于成像区域以外的主动脉远端。在磁共振血管造影中可见6条起源于肾动脉近端30毫米段的动脉分支中的5条。采用最大密度投影或表面渲染后处理显示的肾动脉数量相同，尽管表面渲染在区分重叠静脉与肾动脉方面比最大密度投影技术更好。
这些结果表明，三维磁共振血管造影是显示单一或优势肾动脉的可靠方法，但不能显示所有副肾动脉和小动脉分支。在区分重叠血管中的肾动脉方面，表面渲染可能比最大密度投影具有特定优势。
