Smith P A, Ratner L E, Lynch F C, Corl F M, Fishman E K
Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
Radiographics. 1998 May-Jun;18(3):589-601. doi: 10.1148/radiographics.18.3.9599384.
Laparoscopic nephrectomy (LN) was recently introduced as a minimally invasive alternative to open nephrectomy in living related renal donation. Because of the limited field of view available with laparoscopic techniques, the role of preoperative radiologic evaluation in LN has expanded to include anatomic definition of the renal arteries, collecting system, renal parenchyma, and renal venous anatomy. Computed tomographic (CT) angiography has proved to be a minimally invasive alternative to conventional angiography in the preoperative evaluation of living related renal donors. CT angiography has been shown to have an accuracy comparable to that of conventional angiography in predicting renal arterial anatomy. In addition, CT angiography provides comprehensive definition of the renal vascular anatomy including the location, size, and length of the renal, adrenal, gonadal, and lumbar veins. Dual-phase spiral CT combined with three-dimensional CT angiography constitute a single, minimally invasive procedure that can provide a complete preoperative evaluation of potential living related renal donors prior to LN. Comprehensive anatomic depiction of the renal arterial and venous supplies aids in surgical planning and helps avoid potential complications.
腹腔镜肾切除术（LN）最近作为亲属活体肾移植中开放性肾切除术的一种微创替代方法被引入。由于腹腔镜技术视野有限，术前影像学评估在LN中的作用已扩大到包括肾动脉、集合系统、肾实质和肾静脉解剖结构的解剖学定义。计算机断层扫描（CT）血管造影已被证明是亲属活体肾供体术前评估中传统血管造影的一种微创替代方法。CT血管造影在预测肾动脉解剖结构方面已被证明具有与传统血管造影相当的准确性。此外，CT血管造影可全面定义肾血管解剖结构，包括肾静脉、肾上腺静脉、性腺静脉和腰静脉的位置、大小和长度。双期螺旋CT结合三维CT血管造影构成一种单一的微创检查方法，可在LN术前对潜在的亲属活体肾供体进行全面的术前评估。对肾动脉和静脉供应的全面解剖描述有助于手术规划，并有助于避免潜在并发症。
