Abstract:

BACKGROUND: In recent years, some researchers began to apply a relatively non-invasive multi-slice spiral computerized tomography (CT) to replace digital subtraction angiography (DSA) to evaluate renal anatomy and function of kidney transplantation, but the relevant reports mainly focused on that in the 16-slice (or below) spiral CT, few on the 64-slice spiral CT.
OBJECTIVE: To evaluate the value of 64-slice spiral CT three-dimensional reconstruction in donor and recipient kidney for renal transplantation.
METHODS: Seven patients who were voluntary to donate their one kidney to their relatives and 6 patients who were about to receive kidney from others were done plain CT scan, arterial phase, venous phase and delayed phase enhanced scanning, and enhanced scanning periods were processed with three-dimensional reconstruction techniques including multiplanar reconstruction, volume rendering technique, maximumintensity projection and curved projection reconstruction.
RESULTS AND CONCLUSION: In 7 donors, according to CT angiography, one renal artery in each side of the kidneys was presented in 4 cases, two renal arteries in the left kidney and one in the right in 1 case, three renal arteries in the left kidney and two renal arteries in the right in 2 cases; one renal vein and one set of renal pelvis and ureter were presented in both left and right kidney in all cases. MPR reconstruction showed left renal cyst in 1 case, kidney functions were normal in all cases according to CT urography. The above mentioned results shown by 64-slice spiral CT three-dimensional reconstruction were all proven by surgery. In recipients, according to CT angiography, renal artery, vein and ureter were no stricture and fistula in all 6 cases. CT scanning of 4 cases of the transplanted kidneys showed normal size, normal shape and density. Arterial phase enhanced scanning showed clear boundaries in renal cortex and renal medulla, and CT values were greater than 150 HU. Venous phase enhanced scanning showed the renal parenchyma uniform, CT urography showed urinary function normal. Artery enhanced scanning of 2 cases of the transplanted kidney showed unclear boundaries in renal cortex and renal medulla, CT values less than 100 HU. Venous phase enhanced scanning showed the kidney parenchyma were weak, delayed 10-minute scanning showed only a small amount of contrast medium excretion, which confirmed rejection by renal biopsy. 64 slice spiral CT three dimensional reconstruction can basically replace other imaging examinations before and after renal transplantation, and can be the best option for renal transplantation.