Preoperative CTA evaluation on renal arteriovenous anatomy and tumor thrombi of massive renal carcinoma / 中国介入影像与治疗学

ABSTRACT

Objective To observe the value of renal artery plus renal vein CTA in preoperative evaluation on renal arteriovenous anatomy and tumor thrombi of massive renal carcinoma. Methods Renal artery + renal vein CTA obtained with 256-slice spiral CT of 56 patients with renal carcinoma confirmed by postoperative pathology were retrospectively analyzed, and the images were reconstructed. The anatomical situation of renal artery and renal vein, the location and type of tumor thrombi were observed and compared with surgical operation findings. Results All 56 patients had single tumor, located in the left kidney in 26 cases, while in the right kidney in 30 cases. The maximum diameter of tumor was 71-144 mm ([84.33±20.59]mm). There was no significant difference of the variation rate between the healthy side and the affected side of renal arteries nor veins (all P>0.05). CTA showed totally 117 tumor feeding arteries, while 118 tumor feeding arteries were found during operation, and the coincidence rate was 99.15% (117/118). CTA showed 69 draining veins, so did surgical operation, and the coincidence rate was 100% (69/69). CTA showed tumor thrombi infiltrating renal vein in 5 cases (5/56, 8.93%), infiltration of renal vein and inferior vena cava in 9 cases (9/56, 16.07%), including 5 cases of Mayo type 0, 3 cases of type , 4 cases of type Ⅱ, 2 cases of type III, whereas 42 cases (42/56, 75,00%) were found without infiltrating renal vein. Conclusion Preoperative renal artery plus renal vein CTA can accurately evaluate renal arteriovenous anatomy and location and type of tumor thrombi of renal mass renal carcinoma.