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Multidetector CT Angiography for Preoperative Evaluation of Living Laparoscopic Kidney Donors

Satomi Kawamoto1, Robert A. Montgomery2, Leo P. Lawler1, Karen M. Horton1 and Elliot K. Fishman1

1 The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, 601 N. Caroline St., Rm. 3254, Baltimore, MD 21287-0801.
2 Department of Surgery, Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore, MD 21287.



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  		Fig. 1A. —Multidetector CT angiograms in 27-year-old woman, potential kidney donor, with three renal arteries to left kidney. Left anterior oblique volume-rendered three-dimensional (A) and anterior maximum-intensity projection (B) images show three renal arteries (arrows) to left kidney. Upper pole artery was diminutive and was not recorded by three observers, but is seen in retrospect as small artery of less than 2 mm in diameter. Artery was not thought by surgeon to be significant.

 


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  		Fig. 1B. —Multidetector CT angiograms in 27-year-old woman, potential kidney donor, with three renal arteries to left kidney. Left anterior oblique volume-rendered three-dimensional (A) and anterior maximum-intensity projection (B) images show three renal arteries (arrows) to left kidney. Upper pole artery was diminutive and was not recorded by three observers, but is seen in retrospect as small artery of less than 2 mm in diameter. Artery was not thought by surgeon to be significant.

 


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  		Fig. 2A. —Multidetector CT angiograms in 47-year-old man, potential kidney donor, with two renal arteries to left kidney. Anterior volume-rendered three-dimensional (A) and anterior maximum-intensity projection (B) images show two renal arteries (arrows) to left kidney with diminutive upper pole artery of less than 2 mm in diameter that was missed by two observers.

 


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  		Fig. 2B. —Multidetector CT angiograms in 47-year-old man, potential kidney donor, with two renal arteries to left kidney. Anterior volume-rendered three-dimensional (A) and anterior maximum-intensity projection (B) images show two renal arteries (arrows) to left kidney with diminutive upper pole artery of less than 2 mm in diameter that was missed by two observers.

 


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  		Fig. 3A. —Multidetector CT angiograms in 30-year-old man, potential kidney donor, with early branching of upper pole artery. Anterior volume-rendered three-dimensional (A) and maximum-intensity projection (B) images show two renal arteries (straight arrows) to left kidney with early branching of upper pole artery (curved arrow), which branches off within 1.1 cm of its origin.

 


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  		Fig. 3B. —Multidetector CT angiograms in 30-year-old man, potential kidney donor, with early branching of upper pole artery. Anterior volume-rendered three-dimensional (A) and maximum-intensity projection (B) images show two renal arteries (straight arrows) to left kidney with early branching of upper pole artery (curved arrow), which branches off within 1.1 cm of its origin.

 


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  		Fig. 4A. —Multidetector CT angiograms in 47-year-old woman, potential kidney donor, with retroaortic renal vein. Left anterior oblique volume-rendered three-dimensional (3D) image shows duplicated left renal veins (large straight arrows) passing behind aorta. Left renal artery (small straight arrow) also shows early branching (curved arrow).

 


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  		Fig. 4B. —Multidetector CT angiograms in 47-year-old woman, potential kidney donor, with retroaortic renal vein. Right lateral volume-rendered 3D image shows duplicated left renal veins (arrows) passing behind aorta.

 

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