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Helical CT examination of potential kidney donors
A H Dachman1, G M Newmark, M T Mitchell
1Department of Radiology, University of Chicago, IL 60637, USA.
Insights
Helical CT effectively visualizes kidney anatomy for potential donors, showing high concordance with surgery and angiography. Axial images are generally diagnostic, though some small vessels may be missed.
Area of Science:
- Radiology
- Medical Imaging
- Nephrology
Background:
- Kidney donor evaluation requires detailed anatomical assessment.
- Helical CT offers rapid volumetric data acquisition.
- Multiplanar and 3D reconstructions enhance anatomical visualization.
Purpose of the Study:
- To evaluate helical CT for potential kidney donor examination.
- To compare helical CT findings with angiography and surgical outcomes.
- To assess the utility of axial, coronal, and 3D reconstructions.
Main Methods:
- Thirty-six potential kidney donors underwent unenhanced and enhanced helical CT.
- Axial, coronal, and 3D reconstructions were generated.
- CT results were compared with digital angiography (24 cases) and surgery (24 cases).
Main Results:
- Axial CT excelled in detecting accessory arteries and early branching.
- Helical CT showed high concordance with digital angiography (89%) and surgery (98%).
- Coronal and 3D images infrequently altered patient management decisions.
Conclusions:
- Helical CT accurately depicts renal arterial, venous, and ureteral anatomy.
- Axial images are generally sufficient, with multiplanar and 3D views offering supplementary information.
- Minor accessory vessels and occasional renal artery stenosis may be missed with CT alone.
Objective:
The purpose of our study was to evaluate helical CT using axial, coronal, and three-dimensional (3D) reconstruction in the examination of potential kidney donors and to compare the results with angiography and surgery when possible. We also reviewed previously published reports.
Subjects And Methods:
Thirty-six patients underwent unenhanced and enhanced helical CT (3-mm collimation, 150-170 ml of i.v. contrast material injected at 4 ml/sec; pitch 1.5; 17-sec scan delay) with coronal and 3D shaded-surface-display reconstructions made from 1.5-mm overlapping reconstructions. All CT scans were interpreted independently of each other by two observers unaware of other findings. A third observer, who was aware of other findings, also interpreted the images. Results were compared with angiography (24 cases) and surgery (24 cases). Our results are compared with those of other investigators.
Results:
Axial CT was the best method for detecting accessory arteries (24%) and early branching (10%); it also detected relevant venous and ureteral anatomy and incidental findings. The coronal and 3D images rarely added information that resulted in changed patient treatment. CT findings were concordant with those of digital angiography in 89% of kidneys and were 98% concordant with surgery.
Conclusion:
Helical CT can show arterial, venous, and ureteral anatomy and can also show important incidental findings. If only helical CT is used, a few small accessory vessels and an occasional renal artery stenosis may be missed. Axial images are generally diagnostic and may be supplemented by multiplanar and 3D images read concurrently.
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