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Evaluation of the Renal Venous System on Late Arterial and Venous Phase Images with MDCT Angiography in Potential Living Laparoscopic Renal Donors

¹ All authors: The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, 601 N Caroline St., Rm. 3254, Baltimore, MD 21287.

OBJECTIVE. The objective of our study was to assess whether both renal arteries and renal veins can be evaluated using single-phase MDCT data sets alone to eliminate the need for both arterial and venous phase data sets.

MATERIALS AND METHODS. One hundred consecutive potential living renal donors who underwent 4-MDCT were evaluated. CT was performed with 120 mL of IV contrast material at an injection rate of 3 mL/sec. Both late arterial and venous phase acquisitions were obtained at 25 and 55 sec from the start of IV contrast injection, respectively. The number of the right and left renal veins and its anatomic variations were assessed by two reviewers. Late arterial phase images were evaluated initially, and then venous phase images were analyzed to assess opacification of the renal vein and to see whether venous phase data sets changed or added information about the venous anatomy as seen on late arterial phase images.

RESULTS. The retroaortic left renal vein was found in two subjects, and the circumaortic left renal vein was detected in three subjects. The renal veins were adequately opacified on late arterial phase images in all subjects. There were six subjects who had a normal left renal vein with a small posterior branch coursing posterior to the aorta and draining into the inferior vena cava, which were difficult to differentiate from the lumbar vein or ascending lumbar vein; in three of these six subjects, the small posterior branch was opacified only on venous phase images.

CONCLUSION. Late arterial phase images obtained at 25 sec after the start of contrast injection can reveal the renal vein anatomy except for a small posterior branch of the left renal vein difficult to differentiate from the lumbar or ascending lumbar vein, as seen in three subjects. The data suggest that venous phase imaging is not necessary for the evaluation of renal vein anatomy.

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