Evaluation of transplant renal artery stenosis examined by multislice spiral CT angiograph

Objective: To evaluate the value of multislice CT angiography (MSCTA) in transplant renal artery stenosis (TRAS). Methods: Fifteen cases of TRAS underwent enhanced MSCT scanning postoperation. Multi-planar reformation (MPR), CPR (curved-planar reformation), volume rendering (VR), multi-planar volume reformation (MPVR), maximum intensity projection (MIP) and vessel probe (VP) reformation were performed to observe transplant kidney's artery. To analyse all the reconstruction technique and find the advantage and shortage of them. Results: CT findings of TRAS showed local vascular thining and enhanced renal parenchyma degradinged. CT reconstruction technique: 1 Trans-plant kidney's artery of only one case could be shown in the same MPR plane; 2 Transplant kidney's artery of 13 cases could be shown in CPR coronal and sagittal plane; 3 with 15 cases of VR, stage of courser and shape of angiostegnosis could be observed clearly through rotating the reconstruction image from different directions; 4 15 cases of MPVR could reveal transplant kidney's artery and TRAS at the same time; 5 9 cases of MIP could show TRAS in one plane; 6 15 cases of VP could show condition inside the vessel of transplant kidney, with the degree of stenosis appeared clearly. Of 15 cases of TRAS, stenosis occurred in stoma (8 cases), distant place from stoma (4 cases), stoma and distant place form stoma (2 cases), stenosis occurred in whole range (oe case). Conclusion: MSCTA has an important role as an imaging technique to evaluate TRAS of transplant kidney, which can replace DSA. It can reveal the stenosis part of vessel and direct PTA, to evaluate therapeutic effect of endovascular stent placement. MSCTA will be widespread used clinically. (authors)