王迎春,孔延亮,刘钰苇,强永乾.术前CTA评估大体积肾癌肾动静脉解剖及癌栓[J].中国介入影像与治疗学,2020,17(9):561-564
术前CTA评估大体积肾癌肾动静脉解剖及癌栓
Preoperative CTA evaluation on renal arteriovenous anatomy and tumor thrombi of massive renal carcinoma
投稿时间:2020-03-06  修订日期:2020-07-31
DOI:10.13929/j.issn.1672-8475.2020.09.011
中文关键词:  肾肿瘤  肾静脉  肾动脉  肿瘤转移  体层摄影术,X线计算机
英文关键词:kidney neoplasms  renal veins  renal artery  neoplasm metastasis  tomography, X-ray computer
基金项目:
作者单位E-mail
王迎春 铜川市人民医院影像科, 陕西 铜川 727000  
孔延亮 铜川市人民医院影像科, 陕西 铜川 727000  
刘钰苇 铜川市人民医院影像科, 陕西 铜川 727000  
强永乾 西安交通大学第一附属医院影像科, 陕西 西安 710061 imagingqyq@163.com 
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中文摘要:
      目的 观察术前CTA评估大体积肾癌肾动静脉解剖及癌栓的应用价值。方法 回顾性分析56例经术后病理证实肾癌患者术前256层螺旋CT肾动脉+肾静脉CTA,并进行图像重建,观察肾动脉及肾静脉解剖、癌栓位置及分型,并与术中所见对比。结果 56例肿瘤均单发,左肾26例、右肾30例,最大径71~144 mm,平均(84.33±20.59)mm。健侧与患侧肾动脉、肾静脉变异率差异均无统计学意义(P均>0.05)。CTA显示117支肿瘤供血动脉,术中发现118支,符合率99.15%(117/118);CTA示引流静脉69支,术中发现69支,符合率100%(69/69)。CTA示14例存在癌栓,5例(5/56,8.93%)肾静脉浸润,9例(9/56,16.07%)肾静脉+下腔静脉浸润,Mayo癌栓分型为0型5例,Ⅰ型3例,Ⅱ型4例,Ⅲ型2例;42例(42/56,75.00%)未见静脉癌栓。结论 术前肾动脉+肾静脉CTA可较准确评价大体积肾癌肾动静脉解剖、癌栓位置及分型。
英文摘要:
      Objective To observe the value of renal artery plus renal vein CTA in preoperative evaluation on renal arteriovenous anatomy and tumor thrombi of massive renal carcinoma. Methods Renal artery + renal vein CTA obtained with 256-slice spiral CT of 56 patients with renal carcinoma confirmed by postoperative pathology were retrospectively analyzed, and the images were reconstructed. The anatomical situation of renal artery and renal vein, the location and type of tumor thrombi were observed and compared with surgical operation findings. Results All 56 patients had single tumor, located in the left kidney in 26 cases, while in the right kidney in 30 cases. The maximum diameter of tumor was 71-144 mm ([84.33±20.59]mm). There was no significant difference of the variation rate between the healthy side and the affected side of renal arteries nor veins (all P>0.05). CTA showed totally 117 tumor feeding arteries, while 118 tumor feeding arteries were found during operation, and the coincidence rate was 99.15% (117/118). CTA showed 69 draining veins, so did surgical operation, and the coincidence rate was 100% (69/69). CTA showed tumor thrombi infiltrating renal vein in 5 cases (5/56, 8.93%), infiltration of renal vein and inferior vena cava in 9 cases (9/56, 16.07%), including 5 cases of Mayo type 0, 3 cases of type Ⅰ, 4 cases of type Ⅱ, 2 cases of type Ⅲ, whereas 42 cases (42/56, 75,00%) were found without infiltrating renal vein. Conclusion Preoperative renal artery plus renal vein CTA can accurately evaluate renal arteriovenous anatomy and location and type of tumor thrombi of renal mass renal carcinoma.
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