Pre-operative assessment of living renal transplant donors with state-of-the-art imaging modalities: computed tomography angiography versus magnetic resonance angiography in 118 patients

• Published in: World journal of urology 2013-08, Vol.31 (4), p.983-990
• Main Authors: Engelken, F., Friedersdorff, F., Fuller, T. F., Magheli, A., Budde, K., Halleck, F., Deger, S., Liefeldt, L., Hamm, B., Giessing, M., Diederichs, G.
• Format: Article
• Language: English
• Subjects: Angiography - methods; Arterial Occlusive Diseases - diagnosis; Arterial Occlusive Diseases - diagnostic imaging; Arterial Occlusive Diseases - pathology; Contrast Media - adverse effects; Humans; Image Processing, Computer-Assisted - methods; Kidney - blood supply; Kidney - diagnostic imaging; Kidney - pathology; Kidney Transplantation; Living Donors; Magnetic Resonance Angiography; Medicine; Medicine & Public Health; Nephrology; Observer Variation; Oncology; Original Article; Preoperative Care; Renal Artery - diagnostic imaging; Renal Artery - pathology; Retrospective Studies; Tomography, X-Ray Computed; Urology
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-012-1022-y

Purpose To compare current technology multislice computed tomography angiography (CTA) with magnetic resonance angiography (MRA) in the pre-operative evaluation of vascular anatomy of living renal transplant donors. Methods and materials Two hundred and thirty-six kidneys were included in the CTA and MRA analysis. Renal vasculature was evaluated independently by two readers in each modality with a delay of 4 weeks between reading sessions. Surgical correlation on the operated side was available in all patients. The reference standard was defined by surgical correlation and consensus reading of both modalities. Results Detection rate of CTA for arteries was 99.1 and 95.0 % for reader 1 and reader 2, respectively. Detection rate of MRA for arteries was 95.0/94.3 %. Most of the undetected arteries were ≤1 mm diameter (reader 1: 2 of 3 in CTA and 9 of 16 in MRA; reader 2: 11 of 16 in CTA, and 8 of 18 in MRA). Detection rates for arteries ≥2 mm for reader 1/reader 2 were 99.7/98.7 % in CTA and 99.1/97.8 % in MRA, respectively. Detection rates for veins were 99.6/97.4 % in CTA and 97.8/96.9 % in MRA, respectively. Both readers misdiagnosed between 0 and 1 non-present arteries and between 2 and 3 non-present veins in both modalities. Conclusions Modern multislice CT and MRI scanners allow highly accurate evaluation of the vascular anatomy, especially for vessels of ≥2 mm diameter. CTA may provide slightly better depiction of very small arteries; however, this may be reader-dependent. Additional factors affecting the choice of imaging modality should include local availability, cost, and the desire to avoid ionizing radiation in healthy transplant donors.