Mittul Gulati1, Harout Dermendjian2, Ana M Gómez3, Nelly Tan3, Daniel J Margolis3, David S Lu3, H Albin Gritsch4, Steven S Raman3. 1. Department of Radiology, University of Southern California Keck School of Medicine, Los Angeles, CA. 2. Department of Radiology, University of Southern California Keck School of Medicine, Los Angeles, CA. Electronic address: hdermend@usc.edu. 3. Department of Radiology, David Geffen School of Medicine, University Of California Los Angeles, Los Angeles, CA. 4. Department of Urology, David Geffen School of Medicine, University Of California Los Angeles, Los Angeles, CA.
Abstract
PURPOSE: Most living related donor (LRD) kidneys are harvested laparoscopically. Renal vascular anatomy helps determine donor suitability for laparoscopic nephrectomy. Computed tomography angiography (CTA) is the current gold standard for preoperative imaging; magnetic resonance angiography (MRA) offers advantages including lack of ionizing radiation and lower incidence of contrast reactions. We evaluated 3.0T MRA for assessing renal anatomy of LRDs. MATERIALS AND METHODS: Thirty consecutive LRDs underwent CTA followed by 3.0T MRA. Data points included number and branching of vessels, incidental findings, and urothelial opacification. Studies were individually evaluated by three readers blinded to patient data. Studies were reevaluated in consensus with discrepancies revealed, and final consensus results were labeled "truth". RESULTS: Compared with consensus "truth", both computed tomography (CT) and magnetic resonance imaging were highly accurate for assessment of arterial and venous anatomy, although CT was superior for detection of late venous confluence as well as detection of renal stones. Both modalities were comparable in opacification of lower ureters and bladder; MRA underperformed CTA for opacification of upper urinary tracts. CONCLUSIONS: 3.0T MRA enabled excellent detection of comprehensive renal anatomy compared to CTA in LRDs.
PURPOSE: Most living related donor (LRD) kidneys are harvested laparoscopically. Renal vascular anatomy helps determine donor suitability for laparoscopic nephrectomy. Computed tomography angiography (CTA) is the current gold standard for preoperative imaging; magnetic resonance angiography (MRA) offers advantages including lack of ionizing radiation and lower incidence of contrast reactions. We evaluated 3.0T MRA for assessing renal anatomy of LRDs. MATERIALS AND METHODS: Thirty consecutive LRDs underwent CTA followed by 3.0T MRA. Data points included number and branching of vessels, incidental findings, and urothelial opacification. Studies were individually evaluated by three readers blinded to patient data. Studies were reevaluated in consensus with discrepancies revealed, and final consensus results were labeled "truth". RESULTS: Compared with consensus "truth", both computed tomography (CT) and magnetic resonance imaging were highly accurate for assessment of arterial and venous anatomy, although CT was superior for detection of late venous confluence as well as detection of renal stones. Both modalities were comparable in opacification of lower ureters and bladder; MRA underperformed CTA for opacification of upper urinary tracts. CONCLUSIONS: 3.0T MRA enabled excellent detection of comprehensive renal anatomy compared to CTA in LRDs.
Authors: Fernanda Garozzo Velloni; Patrícia Prando Cardia; Ulysses Dos Santos Torres; Marco Antonio Haddad Pereira; Thiago José Penachim; Larissa Rossini Favaro; Miguel Ramalho; Giuseppe D'Ippolito Journal: Radiol Bras Date: 2020 Jul-Aug