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CT angiography for living kidney donors: accuracy, cause of misinterpretation and prevalence of variation.

Chai JW, Lee W, Yin YH, Jae HJ, Chung JW, Kim HH, Park JH - Korean J Radiol (2008 Jul-Aug)

Bottom Line: Four arteries and two veins were missed during the initial CT interpretation due to perception errors (for two arteries and two veins) and technical limitations (two arteries).The circumaortic renal vein and the bilateral inferior vena cava were found in two cases each (1.3%).MDCT provides a reliable method to evaluate the vascular anatomy and variations of living kidney donors.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University College of Medicine, The Institute of Radiation Medicine, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.

ABSTRACT

Objective: To determine the accuracy of the use of multi-detector row CT (MDCT) to predict vascular anatomy in living kidney donors and to reveal the prevalence of vascular variations in a Korean population.

Materials and methods: A total of 153 living kidney donors that had undergone preoperative CT and nephrectomy, either with open or laparoscopic surgery, were selected retrospectively. The initial CT results were compared with the surgical findings and repeated review sessions of CT scans were performed to determine the causes of mismatches in discordant cases.

Results: The accuracy of CT angiography was 95% to predict the number of renal vessels. Four arteries and two veins were missed during the initial CT interpretation due to perception errors (for two arteries and two veins) and technical limitations (two arteries). The prevalence of multiple renal arteries and veins, early branching of a renal artery and late confluence of a renal vein were 31%, 5%, 12%, 17%, respectively. The circumaortic renal vein and the bilateral inferior vena cava were found in two cases each (1.3%). One case (0.7%) each of a retroaortic renal vein and a supradiaphragmatic originated renal artery were found.

Conclusion: MDCT provides a reliable method to evaluate the vascular anatomy and variations of living kidney donors.

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Related in: MedlinePlus

49-year-old female, left kidney donor.A, B. Contrast-enhanced arterial phase axial CT scan images and maximum intensity projection image showing left renal artery with supradiaphragmatic origin (arrowheads in A, B), which is known as rare variation. In this case, left renal artery length was sufficient for donor nephrectomy.
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Figure 2: 49-year-old female, left kidney donor.A, B. Contrast-enhanced arterial phase axial CT scan images and maximum intensity projection image showing left renal artery with supradiaphragmatic origin (arrowheads in A, B), which is known as rare variation. In this case, left renal artery length was sufficient for donor nephrectomy.

Mentions: Thirty-seven kidneys had an early branching renal artery, and 33 kidneys had a late confluence of renal vein. Two kidneys had circumaortic renal veins. Two donor candidates had a bilateral IVC, and one donor had a retroaortic renal vein. In addition, there was one precaval right renal artery and one left renal artery with a supradiaphragmatic origin (Fig. 2). The summarized results of the renal vascular variations are shown in the Table 1.


CT angiography for living kidney donors: accuracy, cause of misinterpretation and prevalence of variation.

Chai JW, Lee W, Yin YH, Jae HJ, Chung JW, Kim HH, Park JH - Korean J Radiol (2008 Jul-Aug)

49-year-old female, left kidney donor.A, B. Contrast-enhanced arterial phase axial CT scan images and maximum intensity projection image showing left renal artery with supradiaphragmatic origin (arrowheads in A, B), which is known as rare variation. In this case, left renal artery length was sufficient for donor nephrectomy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627266&req=5

Figure 2: 49-year-old female, left kidney donor.A, B. Contrast-enhanced arterial phase axial CT scan images and maximum intensity projection image showing left renal artery with supradiaphragmatic origin (arrowheads in A, B), which is known as rare variation. In this case, left renal artery length was sufficient for donor nephrectomy.
Mentions: Thirty-seven kidneys had an early branching renal artery, and 33 kidneys had a late confluence of renal vein. Two kidneys had circumaortic renal veins. Two donor candidates had a bilateral IVC, and one donor had a retroaortic renal vein. In addition, there was one precaval right renal artery and one left renal artery with a supradiaphragmatic origin (Fig. 2). The summarized results of the renal vascular variations are shown in the Table 1.

Bottom Line: Four arteries and two veins were missed during the initial CT interpretation due to perception errors (for two arteries and two veins) and technical limitations (two arteries).The circumaortic renal vein and the bilateral inferior vena cava were found in two cases each (1.3%).MDCT provides a reliable method to evaluate the vascular anatomy and variations of living kidney donors.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University College of Medicine, The Institute of Radiation Medicine, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.

ABSTRACT

Objective: To determine the accuracy of the use of multi-detector row CT (MDCT) to predict vascular anatomy in living kidney donors and to reveal the prevalence of vascular variations in a Korean population.

Materials and methods: A total of 153 living kidney donors that had undergone preoperative CT and nephrectomy, either with open or laparoscopic surgery, were selected retrospectively. The initial CT results were compared with the surgical findings and repeated review sessions of CT scans were performed to determine the causes of mismatches in discordant cases.

Results: The accuracy of CT angiography was 95% to predict the number of renal vessels. Four arteries and two veins were missed during the initial CT interpretation due to perception errors (for two arteries and two veins) and technical limitations (two arteries). The prevalence of multiple renal arteries and veins, early branching of a renal artery and late confluence of a renal vein were 31%, 5%, 12%, 17%, respectively. The circumaortic renal vein and the bilateral inferior vena cava were found in two cases each (1.3%). One case (0.7%) each of a retroaortic renal vein and a supradiaphragmatic originated renal artery were found.

Conclusion: MDCT provides a reliable method to evaluate the vascular anatomy and variations of living kidney donors.

Show MeSH
Related in: MedlinePlus