Abstract:

BACKGROUND: Whether a high specificity, no wound and safety examination method can be used in the diagnosis of transplant renal artery stenosis after kidney transplantation.
OBJECTIVE: To evaluate the diagnostic value of multi-slice spiral CT angiography in the diagnosis of transplant renal artery stenosis.
METHODS: Eleven patients who were doubtful with transplant renal artery stenosis received the transplant renal artery phase enhanced multi-slice spiral CT scanning before operation. The data obtained after scanning was used to process the image after volume rendering, maximum intensity projection, surface reconstruction and multi-planar reconstruction imaging.
RESULTS AND CONCLUSION: All the 11 patients were diagnosed with transplant renal artery stenosis. Multi-slice spiral CT angiography showed that the stenosis degree of 10 patients was 54%-75%, one patients had the stenosis degree that less than 50%. Ten patients had anastomotic stenosis, two patients had truncal stenosis of the renal artery and one patient had transplant renal artery branch stenosis. Multi-slice spiral CT angiography of nine patients showed that the stenosis degree was 75%-95%, and eight patients received stent implantation, one patient had balloon dilatation. One patient was treated with drug therapy and follow-up for 2 years, and 2 years later, the patient suffered renal function further deterioration and refractory hypertension and received stent implantation. One patient was normal in clinical symptoms, and the stenosis degree was less than 50%, and 4-year follow-up results indicated the normal blood pressure and renal function. Among the patients received stent implantation, one patient received balloon dilatation, and the color Doppler flow after 2 years showed the transplant renal artery stenosis, and the multi-slice spiral CT angiography showed the stenosis degree was less than 50%. After followed-up for 51 months, the renal function and the blood pressure were returned to normal level. Multi-slice spiral CT angiography can be used as the basis for the diagnosis of transplant renal artery stenosis, and has some clinical reference value for distinguish the clinically suspected cases, design the treatment options for stent implantation and postoperative follow-up observation.