摘要
目的:研究主动脉夹层的患者肾脏的CT灌注特点,评价其指导手术的意义。方法:采用东芝公司AQUIL-ION ONE 320排CT,对30名诊断主动脉夹层的患者,术前进行双肾血流灌注检查,测量肾血流量参数值。根据肾动脉受累情况,分为真腔组、假腔组、夹层组、骑跨组。真腔组为肾动脉未受累,假腔组为肾动脉起自假腔,夹层组为肾动脉可见内膜片,骑跨组为肾动脉开口骑跨内膜破口。结果:30名患者,右肾动脉正常22例,受累8例,其中右肾动脉起自假腔6例,骑跨内膜破口2例;左肾动脉正常16例,受累14例,其中左肾动脉起自假腔9例,骑跨3例,夹层2例。真腔组、假腔组、夹层组、骑跨组肾皮质血流量参数平均值分别为305.2±7.7,311.2±11.7,126.2±11.6,364.5±12.0;肾髓质血流量参数平均值分别为175.9±7.8,173.2±12.1,89.7±15.3,231.3±8.0。采用t检验,真腔组与夹层组、骑跨组差异显著,P<0.05;与假腔组血流量参数值差异不显著,P>0.05;骑跨组肾血流量大于真腔组、假腔组,夹层组肾血流量小于真腔组、假腔组。结论:肾脏动态CT灌注不但可以观察肾动脉有无夹层或狭窄,还可以反映肾脏的微循环改变。研究主动脉夹层的患者肾脏的CT灌注特点,通过测量肾血流量以判定肾脏的功能,有助于术前的充分准备,指导术中、术后治疗方案,具有重要的临床意义。
Objective：To investigate the renal perfusion in aortic dissection patients using 320-slice CT and to access it＇s clinical value.Methods：30 aortic dissection patients confirmed underwent dynamic volume renal perfusion（5 ml/s,370 mg iodine/ml） before operation with 100 kV,100 mA,rotation time 0.375 s and radiation dose 8.95 msv.Contrast time-density curves and perfusion maps were generated.Four group were divided： normal,false lumen（renal artery arising from false lumen）,dissection（renal artery dissection）,overriding（orifice of renal artery override the ture and false lumen without renal artery dissection）.Statistical analysis was performed using t-test to compare the blood volume of different group.Results：For 30 patients,normal right renal artery were 22,right renal artery arising from false lumen,6,overriding right renal artery 2;normal left renal artery,16,left renal artery arising from false lumen,9,overriding left renal artery,3,left renal artery dissection,2.The average value of renal cortex blood volume of normal,false lumen,dissection,overriding group were 305.2±7.7,311.2±11.7,126.2±11.6,364.5±12.0 separately.The average value of renal medulla blood volume of normal,false lumen,dissection,overriding group were 175.9±7.8,173.2±12.1,89.7±15.3,231.3±8.0 separately.Statistical significance were found between normal and dissection group,normal and overriding group（P0.05）.Conclusion：Renal function is impaired when aortic dissection involve renal artery.It is important to evaluate renal function before aortic dissection operation.The 320-slice CT allows complete dynamic visualization of the kidney and enables calculation of whole organ perfusion maps.Perfusion imaging carries the potential to improve detection of renal dysfunction due to the perfusion differences.
出处
《医学影像学杂志》
2011年第1期40-44,共5页
Journal of Medical Imaging
