CAJ | 학술논문

【目的】探讨64层多排螺旋CT（MSCT）三维血管成像（3D MSCTA）在肾静脉中的诊断价值。【方法】收集拟行活体肾移植术供肾者96例，临床可疑胡桃夹综合征者5例，行64层3D M SC T A ，了解肾脏静脉血管起始、数目、分支走行及管径大小，进一步比较3D MSCTA各种图像后处理重建方法对肾静脉异常的显示效果。【结果】双肾静脉均为一支且其起源与走行正常者66例。肾静脉变异35例：包括2条右肾静脉者4例，3条右肾静脉者2例，主动脉后肾静脉者1例，肾静脉细小（考虑可疑胡桃夹综合征）者5例，性腺静脉和或腰静脉及左肾上腺静脉（左肾静脉常见属支）汇入左肾静脉主干者20例，2条左肾静脉者3例（2条肾静脉分别与腹主动脉前后分别汇入下腔静脉者1例；1条肾静脉汇入下腔静脉、一条肾静脉汇入半奇静脉者1例；1条肾静脉汇入下腔静脉、一条肾静脉汇入左髂总静脉者1例）。与手术所见完全一致者为99例，符合率为98％（99／101）。【结论】64层3D MSCTA结合适当的后处理重建方法可满意显示肾静脉正常解剖及变异情况，是评价各种肾静脉异常的准确、安全方法。
【목적】탐토64층다배라선CT（MSCT）삼유혈관성상（3D MSCTA）재신정맥중적진단개치。【방법】수집의행활체신이식술공신자96례，림상가의호도협종합정자5례，행64층3D M SC T A ，료해신장정맥혈관기시、수목、분지주행급관경대소，진일보비교3D MSCTA각충도상후처리중건방법대신정맥이상적현시효과。【결과】쌍신정맥균위일지차기기원여주행정상자66례。신정맥변이35례：포괄2조우신정맥자4례，3조우신정맥자2례，주동맥후신정맥자1례，신정맥세소（고필가의호도협종합정）자5례，성선정맥화혹요정맥급좌신상선정맥（좌신정맥상견속지）회입좌신정맥주간자20례，2조좌신정맥자3례（2조신정맥분별여복주동맥전후분별회입하강정맥자1례；1조신정맥회입하강정맥、일조신정맥회입반기정맥자1례；1조신정맥회입하강정맥、일조신정맥회입좌가총정맥자1례）。여수술소견완전일치자위99례，부합솔위98％（99／101）。【결론】64층3D MSCTA결합괄당적후처리중건방법가만의현시신정맥정상해부급변이정황，시평개각충신정맥이상적준학、안전방법。
[Objective] To explore the use of 3‐dimensional 64‐slice Spiral computed tomography angiogra‐phy (3D MSCTA) in the diagnosis of renal veins .[Methods] A total of 96 cases of potential live renal donor and 5 cases of clinically diagnosed nut‐cracker sign (NCS) were examined by 64‐slice spiral computed tomo‐graphy angiography (CTA) .The origin ,number ,branch ,course and size of renal veins were observed .Fur‐ther comparisons were made for the capacities of deciphering renal vein abnormalities on all kinds of postpro‐cessing reconstruction images of 3D MSCT .[Results]Double renal vein with normal origins and courses were found in 66 cases .Among 35 cases of renal vein variation ,there were double right renal vein ( n =4) ,triple right renal vein ( n=2) ,aortic after renal vein ( n=1) ,small renal vein with suspicious nutcracker syndrome ( n =5) ,gonadal and/or lumbar vein and left adrenal vein (left renal vein common genus branch ) entering left renal vein ( n=20) and double left renal veins ( n=3) ,including double renal vein and abdominal aorta ente‐ring before and after veins ( n =1) ,single renal vein entering inferior vena cava & single renal vein entering semi‐azygos vein ( n =1) and single renal vein entering inferior vena cava & single renal vein entering left common iliac vein ( n =1) .The operative findings were consistent completely in 99 cases with a coincidence rate of 98% (99/101) .[Conclusion]3D MSCTA and appropriate postprocessing reconstruction methods may differentiate satisfactorily normal and abnormal anatomies of renal veins .And it is an accurate and safe method of evaluating renal vein abnormalities .