CAJ | 학술논문

目的：评价多层螺旋 CT（MSCT）肾血管成像在肾肿瘤术前评估中的临床应用价值。方法：回顾性分析经手术及病理证实的50例肾肿瘤患者。所有患者均行64层螺旋 CT 肾血管成像检查，应用容积再现（VR）、最大密度投影（MIP）、多平面重建（MPR）等后处理技术进行肾血管重建，评价肾肿瘤与肾门血管、集合系统的关系，肿瘤血供及患肾血管变异情况，并与手术结果对照。结果：50例肾肿瘤患者均获得满意的轴位原始图像，应用 VR、MIP 及 MPR 等后处理技术，显示肾肿瘤位置、范围及与肾门血管、集合系统关系、肿瘤血供及肾静脉变异与术中所见一致。3例肾动脉变异与手术结果不符：1例左侧副肾动脉纤细，供应左肾上极，术中仅见1支左肾动脉；1例左侧4支副肾动脉，术中仅发现3支副肾动脉；1例左肾动脉提前分支，术中误认为左侧2支肾动脉。结论：MSCT 肾血管成像可直观、准确地显示肿瘤位置、范围及与肾门血管、集合系统关系、肿瘤血供及患肾血管变异情况，对指导术者制定手术方案及预防术中并发症有重要的临床意义。
목적：평개다층라선 CT（MSCT）신혈관성상재신종류술전평고중적림상응용개치。방법：회고성분석경수술급병리증실적50례신종류환자。소유환자균행64층라선 CT 신혈관성상검사，응용용적재현（VR）、최대밀도투영（MIP）、다평면중건（MPR）등후처리기술진행신혈관중건，평개신종류여신문혈관、집합계통적관계，종류혈공급환신혈관변이정황，병여수술결과대조。결과：50례신종류환자균획득만의적축위원시도상，응용 VR、MIP 급 MPR 등후처리기술，현시신종류위치、범위급여신문혈관、집합계통관계、종류혈공급신정맥변이여술중소견일치。3례신동맥변이여수술결과불부：1례좌측부신동맥섬세，공응좌신상겁，술중부견1지좌신동맥；1례좌측4지부신동맥，술중부발현3지부신동맥；1례좌신동맥제전분지，술중오인위좌측2지신동맥。결론：MSCT 신혈관성상가직관、준학지현시종류위치、범위급여신문혈관、집합계통관계、종류혈공급환신혈관변이정황，대지도술자제정수술방안급예방술중병발증유중요적림상의의。
Objective:To explore the clinical value of multi -slice spiral CT (MSCT)of renal angiography in re-nal tumor preoperation.Methods:Fifty patients with renal tumor confirmed by operation and pathology were analyzed retrospectively and underwent imaging of 64 slice spiral CT renal angiography,using volume rendering (VR),maxi-mum intensity projection (MIP),multiple planar reconstruction (MPR)and other processing techniques for renal vascular reconstruction,evaluating the relationship between renal tumor and renal hilum,collection system,blood sup-ply of the tumor and renal vascular variation,and comparing the results with operation and pathology.Results:All 50 cases of renal tumor patients were satisfied with the original axial images.Application of VR,MIP,MPR and other post-processing techniques.MSCT renal angiography showed the relations between renal tumor location,scope and renal hilum vascular,collection system,blood supply of the tumor and renal vein variation,consistent with the intraoperative findings.3 cases of renal artery variation and operation results do not match.Left accessory renal artery was slender in a case,supplying the upper pole of the left kidney,not seen in the operation.A case with 4 left accessory renal arteries was found only 3 branches in the operation.Left renal artery was branched in advance in a case,mistaken 2 left bran-ches of renal artery in the operation.Conclusion:MSCT renal angiography can visually,accurately show the location and scope of the tumor,and the relations with renal hilum vascular and renal vascular variation.There was important clinical significance in the guidance of making operation scheme and the prevention of complications of operation.