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The utility of 64 channel multidetector CT angiography for evaluating the renal vascular anatomy and possible variations: a pictorial essay.

Kumar S, Neyaz Z, Gupta A - Korean J Radiol (2010)

Bottom Line: The increased use of laparoscopic nephrectomy and nephron-sparing surgery has prompted the need for a more detailed radiological evaluation of the renal vascular anatomy.Multidetector CT angiography is a fast and accurate modality for assessing the precise anatomy of the renal vessels.In this pictorial review, we present the multidetector CT angiography appearances of the normal renal vascular anatomy and a spectrum of various anomalies that require accurate vascular depiction before undergoing surgical treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

ABSTRACT
The increased use of laparoscopic nephrectomy and nephron-sparing surgery has prompted the need for a more detailed radiological evaluation of the renal vascular anatomy. Multidetector CT angiography is a fast and accurate modality for assessing the precise anatomy of the renal vessels. In this pictorial review, we present the multidetector CT angiography appearances of the normal renal vascular anatomy and a spectrum of various anomalies that require accurate vascular depiction before undergoing surgical treatment.

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Related in: MedlinePlus

Single retroaortic renal vein in 52-year-old female who presented with lower end biliary stricture. Axial maximum-intensity-projection (A) and anterior oblique volume rendered (B) images show single left renal vein coursing posterior to aorta (black arrowheads).
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Figure 13: Single retroaortic renal vein in 52-year-old female who presented with lower end biliary stricture. Axial maximum-intensity-projection (A) and anterior oblique volume rendered (B) images show single left renal vein coursing posterior to aorta (black arrowheads).

Mentions: Other main variants of the left renal vein include a retroaortic left renal vein, double IVC and late confluence of the renal venous trunk. A single retroaortic renal vein is a less common venous anomaly, and this is seen in 1.8-3% of patients (4, 12). A retroaortic left renal vein forms if the dorsal part of the supra-subcardinal vein anastomosis and the intersupracardinal anastomosis persist, whereas the ventral part of the supra-subcardinal anastomosis and the intersubcardinal anastomosis regress. Here, a single left renal vein courses posterior to the aorta and it drains into the lower lumbar portion of the IVC (Fig. 13). Sometimes, the retroaortic renal vein drains into the iliac vein (6). Double IVC is a relatively uncommon condition with a reported incidence of 0.2-3% (9, 14). It results from failure of regression of the embryonic left supracardinal vein. The duplicated left IVC usually drains into the left renal vein, and the left renal vein then crosses anterior to the aorta and joins the right IVC in a normal fashion (Fig. 14). A late venous confluence of the left renal vein is seen in 7-17% of cases (2, 4). On the left side, a late venous confluence is diagnosed when the renal vein branches coalesce within 1.5 cm from the left lateral margin of the aorta (Fig. 15). Preoperative knowledge of the late left venous confluence helps laparoscopic surgeons to anticipate two venous transections if they cannot gain control around the short main renal vein segment. Usually a 5-mm-or-larger gonadal or lumbar vein is present in patients with late venous confluence and it generally it drains into a branch of the main renal vein rather than into the main renal vein itself.


The utility of 64 channel multidetector CT angiography for evaluating the renal vascular anatomy and possible variations: a pictorial essay.

Kumar S, Neyaz Z, Gupta A - Korean J Radiol (2010)

Single retroaortic renal vein in 52-year-old female who presented with lower end biliary stricture. Axial maximum-intensity-projection (A) and anterior oblique volume rendered (B) images show single left renal vein coursing posterior to aorta (black arrowheads).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2864862&req=5

Figure 13: Single retroaortic renal vein in 52-year-old female who presented with lower end biliary stricture. Axial maximum-intensity-projection (A) and anterior oblique volume rendered (B) images show single left renal vein coursing posterior to aorta (black arrowheads).
Mentions: Other main variants of the left renal vein include a retroaortic left renal vein, double IVC and late confluence of the renal venous trunk. A single retroaortic renal vein is a less common venous anomaly, and this is seen in 1.8-3% of patients (4, 12). A retroaortic left renal vein forms if the dorsal part of the supra-subcardinal vein anastomosis and the intersupracardinal anastomosis persist, whereas the ventral part of the supra-subcardinal anastomosis and the intersubcardinal anastomosis regress. Here, a single left renal vein courses posterior to the aorta and it drains into the lower lumbar portion of the IVC (Fig. 13). Sometimes, the retroaortic renal vein drains into the iliac vein (6). Double IVC is a relatively uncommon condition with a reported incidence of 0.2-3% (9, 14). It results from failure of regression of the embryonic left supracardinal vein. The duplicated left IVC usually drains into the left renal vein, and the left renal vein then crosses anterior to the aorta and joins the right IVC in a normal fashion (Fig. 14). A late venous confluence of the left renal vein is seen in 7-17% of cases (2, 4). On the left side, a late venous confluence is diagnosed when the renal vein branches coalesce within 1.5 cm from the left lateral margin of the aorta (Fig. 15). Preoperative knowledge of the late left venous confluence helps laparoscopic surgeons to anticipate two venous transections if they cannot gain control around the short main renal vein segment. Usually a 5-mm-or-larger gonadal or lumbar vein is present in patients with late venous confluence and it generally it drains into a branch of the main renal vein rather than into the main renal vein itself.

Bottom Line: The increased use of laparoscopic nephrectomy and nephron-sparing surgery has prompted the need for a more detailed radiological evaluation of the renal vascular anatomy.Multidetector CT angiography is a fast and accurate modality for assessing the precise anatomy of the renal vessels.In this pictorial review, we present the multidetector CT angiography appearances of the normal renal vascular anatomy and a spectrum of various anomalies that require accurate vascular depiction before undergoing surgical treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

ABSTRACT
The increased use of laparoscopic nephrectomy and nephron-sparing surgery has prompted the need for a more detailed radiological evaluation of the renal vascular anatomy. Multidetector CT angiography is a fast and accurate modality for assessing the precise anatomy of the renal vessels. In this pictorial review, we present the multidetector CT angiography appearances of the normal renal vascular anatomy and a spectrum of various anomalies that require accurate vascular depiction before undergoing surgical treatment.

Show MeSH
Related in: MedlinePlus