Preoperative evaluation of living renal donors: comparison of CT angiography and MR angiography.
OBJECTIVE
To compare computed tomographic (CT) angiography and magnetic resonance (MR) angiography for preoperative evaluation of living renal donors.


METHODS
Thirty-five living renal donors underwent preoperative contrast material-enhanced CT angiography and gadolinium-enhanced MR angiography. Each study was interpreted by two independent radiologists blinded to all other studies and to interpretations provided by other reviewers. Eighteen kidneys had surgical correlation.


RESULTS
CT demonstrated 33 supernumerary arteries in 19 patients, bilateral solitary arteries in 16 patients, and 18 proximal arterial branches in 16 patients. MR demonstrated 26 supernumerary arteries in 15 patients, bilateral solitary renal arteries in 20 patients, and 21 proximal arterial branches in 16 patients. Interobserver agreements for MR (kappa = 0. 74) and CT (kappa = 0.73) were similar to the agreement between MR and CT (kappa = 0.74). Among the kidneys chosen for nephrectomy, one small accessory artery and one proximal arterial branch were missed with CT and MR. Two of the accessory arteries suggested at CT were not found at nephrectomy. By averaging data for both modalities, supernumerary arteries were present in 49% of kidney donors and were bilateral in approximately 17%. Proximal arterial branches were present in 46% of kidney donors.


CONCLUSIONS
Preoperative CT and MR angiography of the renal arteries in renal donors demonstrate substantial agreement. Interobserver disagreement in the interpretation of CT and MR angiograms is related to 1-2-mm-diameter vessels.
Departments of Radiology, Thomas Jefferson University Hospital, 132 S 10th St, Philadelphia, PA 19107-5244, USA. Ethan.Halpern@mail.tju.edu
E J
EJ
Halpern
D G
DG
Mitchell
R J
RJ
Wechsler
E K
EK
Outwater
M J
MJ
Moritz
G A
GA
Wilson
D000328:Adult; D000792:Angiography; D001158:Arteries / Q000002:abnormalities / Q000473:pathology; D016001:Confidence Intervals; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement; D007472:Iohexol; D007668:Kidney / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology; D016030:Kidney Transplantation; D019520:Living Donors; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D015588:Observer Variation; D011300:Preoperative Care; D011856:Radiographic Image Enhancement; D014057:Tomography, X-Ray Computed; D014513:Ureter / Q000000981:diagnostic imaging; D014680:Veins / Q000473:pathology
D003287:Contrast Media; D007472:Iohexol; D019786:Gadolinium DTPA