A technique of evaluating of pancreas graft perfusion using Dynamic volume computed tomography

Muslimov R.SH. 1, Ternovoy S. K. 2,3 , Serova N.S. 2 , Anisimov Yu.A.1, Storozhev R.V. 1, Pinchuk A.V.1

Purpose. To present the possibilities and methodological aspects of performing low-dose dynamic volume computed tomography with perfusion analysis in patients after pancreas transplantation as a non-invasive method of complex graft evaluation. Materials and methods. The study involved 25 patients (12 men and 13 women) aged 24 to 54 years who underwent combined pancreatic and kidney transplantation for Type I diabetes mellitus. All patients underwent dynamic volume computed tomography (CT) of the whole pancreato-duodenal complex with evaluation of perfusion indices using a 640-slice CT-scanner. Results. According to the dynamic CT data, no infiltrative or destructive changes of the pancreatic graft (PG) parenchyma; dilatation of the main pancreatic duct, pathological fluid accumulations in the abdominal cavity and retroperitoneal space also was not found. There were no vascular complications in 13 patients. The mean arterial blood flow (AF) of the whole parenchyma of the PG was 114.2 ± 26.5 ml / min / 100 g. In 10 patients, there was no blood flow along the superior mesenteric artery; the blood supply to the PG was mediated by a single splenic artery. The mean whole PG’s AF was 127.5 ± 31 ml / min/ 100 g. The absence of contrast on both PG’s arteries combined with a severe decrease in perfusion values was detected in two patients. The average volume of contrast medium was 30 ± 6 ml. Conclusions. The algorithm of technique application presented in the work allows the volume visualization of the entire pancreatoduodenal complex and its vascular pedicle, with the calculation of quantitative values of the arterial blood flow. A dynamic volume CT with an evaluation of the body perfusion is a more perfect and informative survey method than routine computed tomography.
1 - Sklifosovsky Research and Clinical Institute for Emergency Medicine. 2 - I.M. Sechenov First Moscow State Medical University (Sechenov University). 3 - A.L. Myasnikov Russian cardiology Research Center. Moscow, Russia.


 

 

 

 

 

 

Keywords:simultaneous combined pancreas and kidney transplantation, dynamic volume computed tomography, CT body-perfusion.

 

Corresponding author:Muslimov R. Sh., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Muslimov R.SH., Ternovoy S. K., Serova N.S., Anisimov Yu.A., Storozhev R.V., Pinchuk A.V. A technique of evaluating of pancreas graft perfusion using dynamic volume computed tomography. REJR 2017; 7(4):74-82. DOI:10.21569/2222-7415-2017-7-4-74-82.

Received: 20.11.2017 Accepted: 04.12.2017