Preoperative evaluation of vascular Morphology and function of living renal Donors on multi - detector row CT

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Tác giả: Phuoc Hung Duong, Trong Khoan Le, Khoa Hung Nguyen

Ngôn ngữ: eng

Ký hiệu phân loại:

Thông tin xuất bản: Journal of Clinical Medicine – Hue Central Hospital, 2020

Mô tả vật lý: tr.59-69

Bộ sưu tập: Metadata

ID: 375953

 Objectives: Preoperative evaluation of the living renal donors vascular morphology and function with Multi-Detector CT (MDCT). Material and methods: From Jan 2017 to August 2018, when carrying out a cross-sectional study at Cardiovascular Centre of Hue Central hospital, we have performed 64-MDCT with an unenhanced, three enhanced CT scan of arterial, parenchymal and secretory phase and two additional dynamic scans between the arterial and parenchymal phase to assess the renal vascular morphology and function on 154 living renal donors and proceeded to nephrectomy. Renal vascular morphology was compared with operational findings. Renal function calculated on MDCT by the Patlak equation was compared with single photon emission computed tomography (SPECT). Results: 154 living renal donors (male/female: 83.77%/16.23%), mean age was 30.72 ± 8.21 years (Range: 20-60 years). 154 chosen kidneys were proceeded to nephrectomy (right kidneys/left kidneys: 49.35%/50.65%), 76 right chosen kidneys (artery variation/vein variation: 20.51%/32.90%) and 78 left chosen kidneys (artery variation/vein variation: 10.53%/1.28%). CT findings all corresponded with the operation, and the sensitivity, positive predictive value, specialty, and negative predictive value of CT were all 100%. 100% of living donors have normal renal function in the excretory phase at 5 minute after CM and saline 0,9% injection bolus. This allows reducing examination time and radiation exposure with the highest effective dose 13.92mSv. The GFR from CT positively correlated with the GFR from SPECT. For the left kidney, the linear correlation coefficient was r = 0.822 (p <
  0.001) and the linear regression model CT-GFR = 0.847 x SPECT - GFR + 8.513, (F = 317.410, p <
  0.001, t = 3.090, p <
  0.005). For the right kidney, the linear correlation coefficient was r = 0.824 (P <
  0.001) and the linear regression model CT - GFR = 0.832 x SPECT - GFR + 9.433, (F = 320.424, p <
  0.001, t = 3.831, p <
  0.001). Conclusions: MDCT contributes into not only more accurate diagnosis of the vascular morphology but also renal function calculation of living renal donors, helps surgeons make appropriate planning in the operation of chosen kidneys of living renal donors and transplanting into patients.
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