The Application Of MSCTA In Living Renal Donors Before Nephrectomy

ObjectiveTo explore optimal scan time of the renal vien and the value of multi-slice CT angiography (MSCTA) in living renal donors befor nephrectomy.Materials and Methods1. The scanning of renal venous phase:80 patients with non-urinary disease underwent MSCTA by using Siemens dual-source CT scanner.The following scan parameter were used:single tube, voltage 160-260 kv, current 300mA, pitch 0.9-1.2, thickness 0.75mm,interval 0.5mm.A total of 90mL intravenous contrast agent was injected at 3.5-4.0mL/s.80 patients were randomly divided into four groups with 20 patients in everyone by the venous phase 44s,46s,48s,50s respectively. After the scanning was measured separately, the CT value of left renal vein,right renal vein,inferior vena cava obout 2cm above the renal vien entrance.2. The scanning of the living renal donors:40 potential living renal donors underwent MSCTA by using Siemens dual-source CT scanner.The scanning parameters and contrast agent were the same with renal venous phase scan。The scanning time of renal artery and vein was initiated at 24s,46s respectively contrast injection. After the scanning, the multiplannar reformations (MPR),maximum intensity projections (MIP),volume rendering techniques(VRT) and surface shaded display(SSD) were used at workstation for image analysis. Results1. The optimal scan time of renal venous phase:The average CT value of the left renal vein, right renal vein and inferior vena cava reached the maximum at 46s with196.9Hu,198.6Hu,154.8Hu. The images of the renal vein and inferior vena cava were the most clear.2. The results of MSCTA with the living renal donors:In 80 kidneys with 40 cases, MSCTA demonstrated 64 kidneys were supplied by a single branch of renal artery,67 kidneys were drained by a single branch of renal vein,16 kidneys had accessory renal artery,11 main renal arteries existed early branches,2 cases with blood vessel narrowing in the left renal artery or superior mesenteric artery respectively and 1 case had a vascular loop in left renal vein.22 living renal donors in 40 cases underwent nephrectomy, and the intraoperative findings for renal blood vessels were consistent with the results of MSCTA.Conclusion1. It is accurate and reliable in observing the renal blood vessels.2. MSCTA is a convenient,safe,non-invasive and sentive technique, the anatomy and variation of renal blood vessels accurately. It is recommended that MSCTA be the initial modality of choice for evaluating the renal blood vessels before nephrectomy in living renal donors and it is important to improve the success rate of living kidney transplantion.