Korean J Radiol.  2008 Aug;9(4):333-339. 10.3348/kjr.2008.9.4.333.

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

• KMID: 1076459
• DOI: http://doi.org/10.3348/kjr.2008.9.4.333

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.

Keyword

Kidney transplantation; Living renal donor; MDCT angiography; Renal artery

MeSH Terms

Adult
Angiography/*methods/standards
Female
Humans
Kidney/*blood supply/radiography
*Living Donors
Male
Middle Aged
Renal Artery/radiography
Renal Veins/radiography
Retrospective Studies
*Tomography, X-Ray Computed/standards
Young Adult

Figure

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  Fig. 1 31-year-old female, left kidney donor. A, B. Maximum intensity projection image and 3D volume rendered image show bilateral single renal arteries (arrowheads). Two left renal arteries were found during donor nephrectomy. However, retrospective review with knowledge of surgical results revealed only one visible renal artery.

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  Fig. 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.

• 

  Fig. 3 23-year-old female, right kidney donor. One right renal vein was detected at initial CT interpretation, but two right renal veins were found during donor nephrectomy. A, B. Maximum intensity projection image and 3D volume rendered image show two right renal veins. Retrospective review without knowledge of surgical results revealed accessory renal vein (arrowheads in A, B) confluence at lower level of inferior vena cava (arrows in A).

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