Intravenous digital subtraction angiography and helical computed tomography in evaluation of living renal donors.
OBJECTIVE
The present study was carried out to evaluate the accuracy of helical computed tomography (CT) and intravenous digital subtraction angiography (IV-DSA) on anatomical assessment of renal vasculature for living renal donors.


METHODS
Forty-two healthy potential renal donors were prospectively evaluated and 35 subsequently underwent donor nephrectomy after helical CT and IV-DSA evaluation. The vascular and non-vascular findings were compared between the findings on helical CT, IV-DSA and surgery.


RESULTS
Ten prehilar branches and five accessory renal arteries were found at nephrectomy. Overall, operative findings agreed with the findings by IV-DSA in 89% and by helical CT in 83%. In delineating accessory arteries, IV-DSA had a sensitivity of 60% and specificity of 97%, whereas helical CT had a sensitivity of 40% and specificity of 100%. In delineating prehilar branches, IV-DSA had a sensitivity of 90% and specificity of 100%, whereas helical CT had a sensitivity of 70% and specificity of 100%. Accessory arteries and prehilar branches that were not detected by helical CT or IV-DSA, were less than 2 mm in diameter and did not require vascular reconstruction. Renal veins were delineated in 63% by IV-DSA, whereas they were clearly imaged by helical CT in all cases, including a case with a circumaortic renal vein. Non-vascular findings were obtained in 64% by helical CT, including two renal tumors. None of these findings were obtained by IV-DSA.


CONCLUSIONS
Helical CT and IV-DSA provide comparably sufficient information on renal artery vasculature. However, helical CT provides significantly more information on venous and non-vascular findings as a single-imaging modality.
Watarai
Y
Y
Department of Urology, Hokkaido University School of Medicine, Sapporo City General Hospital, Sapporo, Japan. wataarai@med.hokudai.ac.jp
Kubo
K
K
Hirano
T
T
Togashi
M
M
Ohashi
N
N
Usuki
T
T
Takeuchi
I
I
Nonomura
K
K
Koyanagi
T
T
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007668:Kidney / Q000098:blood supply; D016030:Kidney Transplantation / Q000000981:diagnostic imaging*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods
D003287:Contrast Media