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目的:采用MDCTA技术观察肾癌患者患侧肾动脉变异并评价其对根治性肾切除术操作的影响。方法:对109例临床诊断为肾癌的患者术前行CT三期增强扫描,并对动脉期CTA图像进行后处理,观察并记录肾癌患侧变异肾动脉的发生并及可能影响根治性肾切除术的肾动脉因素。结果:肾癌患侧变异肾动脉的发生率为11.9%(13/109),表现为多支肾动脉84.6%(11/13)和过早分支23.1%(3/13),含混合型1例;副肾下极动脉最常见(71.4%),且其开口位置和走行变异较大,其中右侧副肾下极动脉开口位于主肾动脉下为(29.44±15.13)mm,约50%走行于下腔静脉前,50%走行于下腔静脉后;左侧副肾下极动脉开口位于主肾动脉下方(42.55±0.64)mm。结论:CT多期增强扫描动脉期CTA图像可以充分显示肾癌患侧肾动脉变异情况,术前明确变异血管的存在及走行对根治性肾切除术的操作有重要意义。
OBJECTIVE: To evaluate the effect of MDCTA on the ipsilateral renal artery in patients with renal cell carcinoma and to evaluate its effect on radical nephrectomy. Methods: One hundred and nine patients with renal cell carcinoma were enrolled in this study. Three phases of CT scan were performed preoperatively. CTA images of the arterial phase were post-treated. The incidence of renal artery with ipsilateral renal cell carcinoma was observed and recorded. Resection of renal artery factors. Results: The incidence rate of renal artery with ipsilateral renal cell carcinoma was 11.9% (13/109), which was 84.6% (11/13) in multiple renal arteries and 23.1% (3/13) in premature branches, including mixed type 1 For example, the inferior accessory artery is the most common (71.4%), and its position of opening and its variation are larger. The opening of the right accessory kidney inferior artery is (29.44 ± 15.13) mm, about 50% In the inferior vena cava, 50% walk in the inferior vena cava after; the left accessory kidney anorta opening located below the main renal artery (42.55 ± 0.64) mm. CONCLUSIONS: CTA images of multiphase enhanced CT in arterial phase of CT scan can fully show the variation of renal artery in ipsilateral renal cell carcinoma. The existence of preoperative clear vascular changes and its operation are of great significance for the operation of radical nephrectomy.