Role of Multidetector Computed Tomography in the Preoperative - PowerPoint PPT Presentation

Role of Multidetector Computed Tomography in the Preoperative Evaluation of Donor Kidney Afak Durur Karakaya,Department of Radiology, Istanbul Medipol University, Istanbul, Turkey. Akin Levent,Department of Radiology, Ataturk University, Faculty of Medicine, Erzurum, Turkey.

• Multi-detector computed tomography (MDCT) is an effective, fast, relatively non-invasive Introduction/Background method for the preoperative evaluation of renal vascular structures.

• This prospective study aimed to explore the role Objective/Purpose of MDCT in the pre-operative evaluation of living donor kidneys.

Imaging Technique and Assessment • The images of the donors were taken preoperatively using MDCT angiography. • (Toshiba aqullion 16 dedector CT, 16x0.5 mm colimation, 1,0 mm slice thickness, 1,0 mm interslice gap). • Nonionic contrast material with iodine with automatic injector was applied with a speed of 4 – 4,5 ml/s. (90 cc, 300 mg/ml) • The contrasted images were taken in the 35th second following IV contrast material injection.

Imaging Technique and Assessment • T T The images T he images he images he images • T T The axial original images, T he axial original images, he axial original images, he axial original images, • Multiplanar Multiplanar Multiplanar reconstruction Multiplanar reconstruction reconstruction reconstruction (MPR) (MPR) (MPR) (MPR) • Volume Volume Volume rendering Volume rendering rendering rendering • Maximal Maximal intensity Maximal Maximal intensity intensity intensity projection projection projection projection (MIP) (MIP) (MIP) (MIP) • 48 adult volunteers 48 adult volunteers 48 adult volunteers 48 adult volunteers • Patients were examined for appropriateness for transplantation. Patients were examined for appropriateness for transplantation. Patients were examined for appropriateness for transplantation. Patients were examined for appropriateness for transplantation. • Vascular findings on MDCT were compared to operative findings by Vascular findings on MDCT were compared to operative findings by Vascular findings on MDCT were compared to operative findings by Vascular findings on MDCT were compared to operative findings by Pearson’s correlation test for the operated patients Pearson’s correlation test for the operated patients Pearson’s correlation test for the operated patients Pearson’s correlation test for the operated patients

Imaging Technique and Assessment • In the donors, • Renal parenchym, • Renal vascular structure • Intraabdominal pathologies • Renal artery • Polar accessory • Hilar accessory. • Early branching • The renal veins were named according to the relations with the vena cava inferior. • Retroaortic • Circumaortic

Findings and cases • 48 48 48 patients 48 patients patients patients (25 (25 (25 (25 - -60 - - 60 60 60 age age age) age ) ) ) • 30 30 30 30 males males males, 18 males , 18 females , 18 , 18 females females females. . . . • Of Of these Of Of these patients these these patients patients patients, , , , only only 28 only only 28 28 28 were were were were found to found to be be convenient convenient donors donors. . found found to to be be convenient convenient donors donors . .

Findings and cases • In the parenchymal assesment � Simple cyst � Kidney stone In the arterial assessment • � Early branching (3) � Left accessory renal artery (5) � Right accessory renal artery (2) � Bilateral accessory renal artery (2) In the venous assessment, we found 4 cases. • � They were all on the left. � Circumaortic renal vein (1) � Retoaortic renal vein (3).

When assessing the donor, kidney MDCT enables us to localisation and evaluate both the size, renal vascular MDCT is a fast, non- renal parancim and structure, and the invasive method with the vascular existence of tumour a low morbidity (1,2). structures together diseases (3,4). accompanied must be well known. Discussion

• MDCT is a non-invasive, cheap, easy imaging Conclusion method with a temporal and spatial high resolution.

References 1. Kawamoto S, Montgomery RA, Lawler LP, et al. Multidetector row CT evaluation of living renal donors prior to laparoscopic nephrectomy. Radiographics 2004; 24: 453–466. 2. Kim JK, Park SY, Kim HJ, et al. Living donor kidneys: usefulness of multi detector row CT for comprehensive evaluation. Radiology 2003;229:869–876. 3. Rubin GD, Alfrey EJ, Dake MD, et al. Assessment of living renal donors with spiral CT. Radiology; 1995;195:457–462. 4. Platt JF, Ellis JH, Korobkin M, et al. Potential renal donors: comparison of conventional imaging with helical CT. Radiology 1996;198:419–423.