3.0Tesla magnetic resonance angiography (MRA) for comprehensive renal evaluation of living renal donors: pilot study with computerized tomography angiography (CTA) comparison

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 adva...

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Bibliographic Details
Published in:Clinical imaging 2016-05, Vol.40 (3), p.370-377
Main Authors: Gulati, Mittul, Dermendjian, Harout, Gómez, Ana M., Tan, Nelly, Margolis, Daniel J., Lu, David S., Gritsch, H. Albin, Raman, Steven S.
Format: Article
Language:English
Subjects:
Acquisitions & mergers
Adult
Anatomy
Angiography
Bladder
Computation
Computed Tomography Angiography
Computer aided tomography
Contrast agents
Coronary vessels
CTA
Donor Selection - methods
Female
Humans
Imaging
Iodine
Kidney - blood supply
Kidney - diagnostic imaging
Kidney - surgery
Kidney Transplantation
Kidneys
Laparoscopic nephrectomy
Laparoscopy
Living Donors
Magnetic resonance
Magnetic Resonance Angiography - methods
Male
Medical imaging
Middle Aged
MRA
Nephrectomy - methods
Pilot Projects
Prospective Studies
Readers
Renal donor
Single-Blind Method
Studies
Tomography
Transplants & implants
Urogenital system
Veins & arteries
Visualization
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Description
Summary: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. 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”. 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. 3.0T MRA enabled excellent detection of comprehensive renal anatomy compared to CTA in LRDs.
ISSN:0899-7071
1873-4499
DOI:10.1016/j.clinimag.2016.01.010