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Left infrarenal region: anatomic variants, pathologic conditions, and diagnostic pitfalls
S B Gay1, J P Armistead, M E Weber
1Department of Radiology, University of Virginia Health Sciences Center, Charlottesville 22908.
Summary
Computed tomography (CT) is key for evaluating the left periaortic infrarenal region. Awareness of normal anatomy and variants is crucial for accurate diagnosis of abnormalities like lymphadenopathy or vascular issues.
Area of Science:
- Radiology
- Medical Imaging
- Anatomy
Background:
- The left periaortic infrarenal region requires precise evaluation.
- Computed tomography (CT) is the primary imaging modality for this area.
- Identifying abnormalities necessitates a thorough understanding of regional anatomy.
Purpose of the Study:
- To outline the diagnostic utility of CT in the left periaortic infrarenal region.
- To highlight common anatomical variants that can complicate diagnosis.
- To emphasize the importance of recognizing normal structures and potential pitfalls in CT interpretation.
Main Methods:
- Review of computed tomography (CT) imaging protocols for the left periaortic infrarenal region.
- Analysis of anatomical structures and common variations.
- Identification of CT imaging artifacts and technical challenges.
Main Results:
- Structures >11 mm in diameter in this region warrant evaluation for lymphadenopathy, hydroureter, or vascular abnormalities (e.g., venous thrombosis, varicoceles).
- Normal structures include the inferior mesenteric vessels, left gonadal vein and artery, and ureter.
- Anatomical variants such as double IVC, retroaortic/circumaortic left renal vein, and renal anomalies can mimic pathology.
Conclusions:
- Accurate CT interpretation of the left periaortic infrarenal region depends on familiarity with normal anatomy and its variants.
- Awareness of potential CT technique issues is vital to prevent diagnostic errors.
- A systematic approach ensures comprehensive evaluation and accurate diagnosis.