Preoperative evaluation of live renal donors using multislice CT angiography

• Published in: Clinical radiology Vol. 60; no. 7; pp. 771 - 777
• Main Authors: Johnson, J.E., Loveday, E.J., Archer, L.J., Lear, P., Thornton, M.J.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01.07.2005; Elsevier
• Subjects: Adult; Aged; Biological and medical sciences; Cardiovascular system; Computed tomography (CT); Female; Humans; Investigative techniques, diagnostic techniques (general aspects); Kidney transplantation; Living Donors; Male; Medical sciences; Middle Aged; Preoperative Care; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Renal angiography; Renal Artery - abnormalities; Renal Artery - diagnostic imaging; Retrospective Studies; Sensitivity and Specificity; Tomography, X-Ray Computed - methods; Renal angiography; Computed tomography (CT); Kidney transplantation; Human; Radiodiagnosis; Angiography; Transplantation; Kidney; Treatment; Donor; Surgery; Graft; Medical imagery; Multislice; Computerized axial tomography; Preoperative
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2004.12.007

To determine the accuracy of multidetector row CT renal angiography in the preoperative evaluation of live kidney donors, and to identify potential pitfalls when reporting. Between July 1998 and June 2003, 74 consecutive live renal donors underwent contrast-enhanced multidetector row CT renal angiography before donor nephrectomy. The operative notes and radiological reports of all cases were reviewed retrospectively. Where a significant discrepancy was identified, the archived images were reviewed by two radiologists in the light of the intraoperative findings. A total of 12 discrepancies were identified in 11 of the 74 cases (15%). In the preoperative CT angiography reports, 4 accessory arteries, 6 early-branching renal arteries, 1 duplicated renal vein and 1 accessory ureter were not identified; 9 of these were evident on review, but were not detected at the time of reporting. In 3 cases (1 accessory artery, the duplicated renal vein and the accessory ureter), the anomaly was not visible on review of the CT angiographic data, even with the benefit of hindsight. Surgical feedback during the study period resulted in modifications to CT technique and improved performance. In the majority of cases, there was good correlation between preoperative CT renal angiography and operative findings. Most discrepancies were due either to an oversight by the reporting radiologist, or failure to fully appreciate the potential surgical significance of certain findings. Regular surgical feedback plays a valuable role in improving reporting accuracy and maintaining imaging standards.