Preoperative Use of 3D Volume Rendering to Demonstrate Renal Tumors and Renal Anatomy

Autor: Andrew C. Novick, Brian R. Herts, Deirdre M. Coll, William J. Davros, Robert G. Uzzo
Rok vydání: 2000
Předmět:
Zdroj: RadioGraphics. 20:431-438
ISSN: 1527-1323
0271-5333
DOI: 10.1148/radiographics.20.2.g00mc16431
Popis: With increased us of computed tomography (CT) and abdominal ultrasonography, the indications for nephron-sparing surgery are also increasing. Triphasic helical CT and three-dimensional (3D) volume rendering can be combined into a single noninvasive test to delineate renal tumors and normal and complex renal anatomy prior to nephron-sparing surgery. This combination technique has provided accurate and very useful for both preoperative and intraoperative planning by demonstrating renal position, tumor location and depth of tumor extension into the kidney, relationship of the tumor to the collecting system, and renal vascular anatomy. Knowledge of the position of the kidney relative to the lower rib cage, iliac crest, and spine helps in planning the initial surgical incision. By depicting tumor location and depth of extension, helical CT with 3D volume rendering helps ensure complete tumor excision and conservation of adjacent normal renal parenchyma. Depiction of the relationship of the tumor to the collecting system helps anticipate further tumor extension and minimize postoperative complications. Identification of normal renal vasculature and anatomic variants can help minimize ischemic injury and intraoperative bleeding. Radiologists should be familiar with current indications for nephron-sparing surgery and understand what information is required prior to surgery. The authors underscore the value of helical CT with 3-dimensional imaging in the approach to nephron-sparing surgery for localized renal cancers. The authors suggest, and I agree, that this technique can markedly reduce the need for invasive arteriographic imaging in these patients. The ability of this technique to identify the renal vasculature may prove particularly useful in cases where difficult partial nephrectomy is contemplated. Robert Flanigan, M.D.
Databáze: OpenAIRE