Contrast-enhanced three-dimensional fast-spoiled gradient magnetic resonance angiography of the renal arteries for potential living renal transplant donors: A comparative study with digital subtraction angiography

Variations of renal artery in 820 patients using 64-detector CT-angiography

PURPOSE

Renal artery variations are important for clinical reasons. The aim of this study is to determine the originating level and variations of renal arteries with 64-channel multidetector computed tomography (MDCT).

MATERIALS AND METHODS

In a university hospital, 820 patients who underwent MDCT angiography of the abdominal aorta were retrospectively evaluated. The number, early division (ED), and originating level of renal artery were evaluated retrospectively. Variations of the renal artery on both sides, the difference between the genders with variations of the renal artery, were compared with chi-square test.

RESULTS

Renal artery originating from the level of L1-L2 intervertebral disc was found in 37.0% and 38.9% of patients on the right and left sides, respectively. Renal artery variations, including extrarenal artery (ERA), were found in 27% and ED in 26.7% of the patients. Significant differences were found in ED and ERA prevalence for genders (p = 0.006 and p = 0.043, respectively). The prevalence of both variations is higher in males.

CONCLUSIONS

An awareness of renal vascular variations is very important for both surgeons and radiologists. In this series, renal arterial variations were found in approximately one-fourth of the study population.

Three-dimensional reconstruction on PC-Windows platform for evaluation of living donor nephrectomy

Evaluation of renal vasculature was necessary for preoperative donor assessment in living donor kidney transplantation, and the ability to view the vascular imaging in three-dimensional (3D) space should be helpful undoubtedly. Considering the widespread use of personal computer (PC) systems, we aimed to find a handy way to display the anatomy of the renal arterial and venous systems of potential donors on PC-Windows platform. Ten living-related donors were included in this study. Serial computed tomography (CT) images were loaded into Amira 3.1 running on a PC with Windows XP. Following image crop, segmentation and 3D reconstruction, we got the 3D images and the video clips. According to the displays which were confirmed by latter intraoperative findings, eight donors had single renal vessels, one had a left accessory renal artery and one had a right accessory renal artery. This project offered a new approach to evaluate the renal vessel anatomy in living donor kidney transplantation, and it was favorable for accuracy and popularizing.

Assessment of the arteries in living kidney donors: correlation of magnetic resonance angiography with intraoperative findings

Comprehensive imaging evaluation of kidney donor anatomy is crucial for selecting candidates for living kidney transplantation and for determining the surgical technique to procure the renal graft. In 76 living renal donors we compared the results of preoperative magnetic resonance angiography (MRA) with the intraoperative findings of arterial anatomy. Donors were evaluated for the number of main renal arteries and the presence of any polar arteries. A total of 80 main renal arteries and five polar arteries were observed at MRA. At surgery, 90 main renal arteries and eight polar arteries were identified. MRA demonstrated a sensitivity, specificity, and overall accuracy of 18%, 98%, and 87%, respectively, for main arteries and 25%, 96%, and 88% for polar arteries. Eleven (14.5%) kidneys displayed more than one main artery and MRA only detected two cases. Eight kidneys had polar arteries and MRA only detected two cases. MRA is a reliable method for presurgical evaluation of renal arteries in potential donors, providing valuable information required by the surgeon. But, as the technique misses small-diameter vessels, it cannot be recommended as the sole diagnostic tool in unclear cases.

Renal MR and CT angiography: current concepts

During the past decade, noninvasive CTA and MRA imaging techniques have replaced catheter angiography for evaluation of the renal arteries. This article reviews techniques for optimizing renal MRA and CTA, assesses the advantages and limitations of MRA and CTA, and provides the current indications for renal vascular imaging including renal artery stenosis screening. New and future developments in these rapidly evolving techniques are also discussed.