MSCT Study Of Post Simultaneous Pancreatic-kidney Transplants

Objective: To evaluate the value of Multi-slice CT (MSCT) and postprocessing techniques in evaluation of normal findings and complications after simultaneous pancreatic-kidney transplantation.Subjects and methods: Twenty-five MSCT imaging studies were performed in twenty-two patients underwent simultaneous pancreatic-kidney transplantation with a MSCT scanner (GE Lightspeed 16 CT) with a slice-thickness of 10mm before and after contrast material was administered with a power injector. Twenty-four studies were performed within 2 months after transplantation, with a mean time of study after surgery of twenty-three days (range, 16days to 38 days) except one study was performed 10 months after surgery. Source images were reconstructed into images with slice-thickness of 1.25mm and were transported into a workstation(GE AW4.0) with which post process was conducted.We evaluate MIP and VR in demonstrating vessels of transplants.Beyond these,we calculate MPPE of pancreas transplants in arterial phase comparing with clinical results.Results: In 25 cases of transplant pancreases, MSCT found 20 normal pancreas parenchyma grafts, one case of acute rejection with intrapancreatic splenic arterial thrombosis, one case of indefinable boundary,one case of many peripancreatic and perikidney abscesses formations;one case of peripancreatic inflammation. In 25 cases of transplant kidneys, MSCT identified 21 normal kidney grafts and one case of mild acute rejection and MSCTA detected two sites of transplant renal arterial stenosis in one case and one venoma in another. In 24 MSCTA studies,the detection rate of common hepatic artery, splenic artery, superior mesenteric artery, superior pancreaticoduodenal artery, inferior pancreaticoduodenal artery were 96%,96%, 88%,58%,63%,and 96%,96%,88%,29%,33% of MIP and VR, respectively.As for MPPE results,one case of pancreas infarction has a MPPE of 9%,another 21 normal pancreas has MPPE ranged from 75%-178%(average 119%),the other 3 dysfunctional pancreas has a MPPE of 144%,85%,110% respectively.Conclusion: MSCT with its post-processing technique is helpful for evaluation of post simultaneous pancreatic-kidney transplants.In demonstrating superior pancreaticoduodenal artery and inferior pancreaticoduodenal artery,MIP is superior to VR.MPPE results can identify pancreas infarction,but it has limitations in evaluating other mild pancreatic dysfunctions.