| Obejeetive:The purpose of this paper was to investigate the value of DSCT in the preoperative comprehensive assessment of living related renal donors.Materials and Methods:Data of 31 cases of living relative kidney transplantation performed between July 2007 and Decemember 2008 were studied retrospectively. All the donors(11 men and 20 women;range of age,31-68 years old,mean age,48.6 years old) were underwent abdominal DSCT multiphase scan to evaluate preoperatively.The dual-source computed tomography(DSCT) protocol consisted of a plain examination followed by multiphase contrast material enhanced examinations (contrast media injection rate 4ml/min,dose of 1.5ml/kg),vein and excretory phase examinations were performed 55s,300s respectively after starting of contrast media injection,and four scanning of both kidneys were performed after arterial phase(45s,65s,85s,105s after starting of contrast media injection,).The DSCT raw images of 31 cases were transported to workstation to reconstruct.All the images were reconstructed by maximum intensity projection(MIP),volume rendering(VR) technique before operation for assessing the anatomical condition of the renal arteries and veins,the urinary tract.Anatomical results showed with DSCT were compared with intraoperative findings.Using Patlak plot equation,the GFR was calculated in DSCT scan and the exact information of GFR were obtained by performing renal SPECT in 28 cases.GFR of the two groups were analyzed by linear regression and correlation,and paired t test were applied.Result:The examination time of all the RLDs was 6-8 minutes.No contrast media adverse effect happened in all the RLDs.All the images display the renal vascular, parenchyma and collecting system clearly.Eight kidneys were found with nine accessory arteries(6 left kidneys,2 right kidneys).Three kidneys were found 3 early branches of renal artery(2 left kidneys,1 right kideny).Of all the 62 renal veins,1 retroaortic left renal vein and 1 accessory vein were found.In the excretory phase,all the collecting system was displayed well,without any abnormality.Three kidneys were found cysts in the parenchyma.Renal arteries,veins,parenchyma and the collecting system of renal donors showed with DSCT were in accord with surgical findings.The GFR were calculated in DSCT scan and the GFR were obtained by performing renal SPECT have very well associativity,the correlation coefficient of whole kidney and divided one is 0.788 and 0.93,with a line of regression GFR(DSCT)=43.54+0.586xGFR(SPECT),n=28(whole kidney),GFR(DSCT)= 11.69+0.784xGFR(SPECT),n=56,they have no statistical significance in paired t test(P＞0.05).Conclusion:With only one examination,DSCT not only can provide accurate information regarding the anatomy of the urinary tract and vasculature of the kidney but also can measure GFR.GFR measured with SPECT and DSCT have very well associativity.Therefore,it is one of good moldalities for preoperative comprehensive assessment of living renal donors. |
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