title: Computerized tomography with 3-dimensional reconstruction for the evaluation of renal size and arterial anatomy in the living kidney donor.
abstract: OBJECTIVE
  Computerized tomography (CT) with 3-dimensional (3-D) reconstruction has gained acceptance as an imaging study to evaluate living renal donors. We report our experience with this technique in 199 consecutive patients to validate its predictions of arterial anatomy and kidney volumes.
  
  
  METHODS
  Between January 1997 and March 2002, 199 living donor nephrectomies were performed at our institution using an open technique. During the operation arterial anatomy was recorded as well as kidney weight in 98 patients and displacement volume in 27. Each donor had been evaluated preoperatively by CT angiography with 3-D reconstruction. Arterial anatomy described by a staff radiologist was compared with intraoperative findings. CT estimated volumes were reported. Linear correlation graphs were generated to assess the reliability of CT volume predictions.
  
  
  RESULTS
  The accuracy of CT angiography for predicting arterial anatomy was 90.5%. However, as the number of renal arteries increased, predictive accuracy decreased. The ability of CT to predict multiple arteries remained high with a positive predictive value of 95.2%. Calculated CT volume and kidney weight significantly correlated (0.654). However, the coefficient of variation index (how much average CT volume differed from measured intraoperative volume) was 17.8%.
  
  
  CONCLUSIONS
  CT angiography with 3-D reconstruction accurately predicts arterial vasculature in more than 90% of patients and it can be used to compare renal volumes. However, accuracy decreases with multiple renal arteries and volume comparisons may be inaccurate when the difference in kidney volumes is within 17.8%.
authors.affiliation: Department of Surgery, Oregon Health and Science University, Portland, USA.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Janoff
authors.forename: Patrick
authors.initials: P
authors.lastname: Davol
authors.forename: James
authors.initials: J
authors.lastname: Hazzard
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Lemmers
authors.forename: Darius A
authors.initials: DA
authors.lastname: Paduch
authors.forename: John M
authors.initials: JM
authors.lastname: Barry
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007668:Kidney / Q000098:blood supply* / Q000000981:diagnostic imaging*; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed