MULTIDETECTOR COMPUTED TOMOGRAPHY OF RENAL VASCULATURE. ANATOMY AND NORMAL VARIANTS.

Abstract

Multi Detector Computed Tomography Angiography (MDCTA) provides a fast, non-invasive modality for the evaluation of the renal vascular pedicle. CTA can reliably and accurately depict the renal arteries and veins and approaches conventional angiography in the assessment of most vascular abnormalities. Knowledge of the variations in renal vascular anatomy is important before laparoscopic donor or partial nephrectomy and vascular reconstruction for renal artery stenosis or abdominal aortic aneurysm.
Objective: To illustrate the diagnostic accuracy of MDCT for evaluation of renal vasculature anatomy.
Design: An analytic, comparative study.
Subjects: fifty six patients including 43 living renal donors, 13 hypertension and abdominal pain (27 men and 29 women, mean age 39.5 years) were examined from January 2008 to September 2010 in Radiology department, Farwania hospital Kuwait. Gold standard was the operative data, conventional angiography or DSA.
Main outcome: The value of MDCT in assessment of renal vascular anomalies.
Results: Renal vascular anatomical variants included multiple arteries (21.4%), multiple veins (7.1%), early arterial bifurcation (8.9%), late venous confluence (7.1%), circum-aortic renal veins (7.1%) and retro-aortic vein (3.6%). The sensitivity and specificity of multiple arterial anomalies were 91.7% and 97.7%, respectively. The sensitivity and specificity of multiple venous anomalies were 85.7% and 97.6%, respectively.
Conclusion: MDCT is valuable for detection of renal vascular anomalies.
Keywords: Renal artery. Renal vein. Kidney. Multi-detector computed tomography