多层螺旋CT对移植肾并发症评价.docVIP

多层螺旋CT对移植肾并发症评价 　 作者：孙志强，罗莉漫，黄文才，高娟，刘忠，阳昱恒，曾晓华 【摘要】 　　目的 评价多层螺旋CT及后处理技术对肾脏移植术后肾功能及术后并发症的诊断价值。方法 21例接受肾脏移植手术的患者，行16层螺旋CT平扫及增强多期扫描，并同时对所得图像数据不同期像进行特定的三维重建，三维重建方法包括：最大密度投影（MIP）、多平面重建（MPR）与曲面重建(CPR)、表面遮盖成像（SSD）、容积再现技术（VR）。结果 21例患者中5例仅表现为移植肾肿胀，8例表现为移植肾肿胀并肾周积液；1例为双肾萎缩伴功能丧失；2例表现为移植肾周积血；1例表现为移植肾多发小囊肿、小结石并肾周积液；1例表现为移植肾输尿管旁尿瘘伴输尿管狭窄及肾积水、亚段肾梗死；1例表现为移植肾积水并输尿管结石；1例表现为移植肾肿胀，肾盂内积脓；1例表现为移植肾破裂。 结论 16层螺旋CT及后处理技术对肾脏移植术后肾功能及肾脏形态学表现进行初步评价，对移植肾并发症的早期诊断有较高的评估价值。 【关键词】 肾脏；移植；体层摄影术，X线计算机；后处理 　　Abstract： Objective To evaluate the diagnosis value of multislice spiral computerized tomography (CT) on renal function and complications after kidney transplantation.Methods A total of 21 patients with kidney transplantation were subjected to spiral CT plain scan and multi-phase enhancement scan, and 3Dreconstruction was performed with the scanning images of different phases. The methods of 3Dreconstruction included maximum intensity projection (MIP), multi planar reconstruction (MPR) and curved planar reformation (CPR), surface shaded display (SSD), volume rendering technique (VR). Results Of the 21 patients, 5 showed transplanted kidney swelling alone, 8 showed transplanted kidney swelling and perinephric dropsy, 1 showed atrophy and function failure of both kidney, 2 showed perinephric hemorrhage, 1 showed multiple small cysts, small calculi and perinephric dropsy of transplanted kidney, 1 showed ureteral fistula, ureteral stricture, hydronephrosis and infarct of subsegment kidney, 1 showed hydronephrosis and ureteral calculi, 1 showed swelling and pyonephrosis, and 1 showed rupture of transplanted kidney.Conclusion The primary evaluation of 16slice spiral CT and postimaging processing techniques on renal function and morphological features after kidney transplantation is highly valued on the early diagnosis of complications of kidney transplantation. 　　Key words： kidney; transplantation; tomography; Xray computerization; postimaging processing 近年来肾脏移植已经成为治疗许多终末期肾病病人的有效手段，随着肾移植外科技术的改进和新型免疫