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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.

View larger version (174K): [in a new window]   Fig. 1A. —31-year-old woman with retroaortic renal vein and two left adrenal veins. Late arterial phase anterior reformatted image shows that bifurcating retroaortic renal vein is opacified. Bridging vein between bifurcated renal veins on left side of aorta (black arrow) can be seen. One of two adrenal veins (white arrowhead) drains into bifurcated renal vein near aorta, and left gonadal vein (white arrows) is opacified. Incidental enhancing nodule in right lobe of liver (black arrowhead) is consistent with hemangioma.

View larger version (125K): [in a new window]   Fig. 1B. —31-year-old woman with retroaortic renal vein and two left adrenal veins. Venous phase anterior reformatted image obtained slightly anterior to A shows that second left adrenal vein drains into renal vein near bifurcation (arrowhead). This vein also was opacified on late arterial phase image (not shown).

View larger version (105K): [in a new window]   Fig. 1C. —31-year-old woman with retroaortic renal vein and two left adrenal veins. Late arterial phase superior volume-rendered 3D image shows retroaortic course of left renal vein (arrowheads).

View larger version (121K): [in a new window]   Fig. 2. —49-year-old woman with circumaortic renal vein. Late arterial phase anterior oblique volume-rendered 3D image shows bifurcating left renal veins draining into inferior vena cava anterior (arrow) and posterior (arrowheads) to aorta. Both preaortic and retroaortic components are opacified. In this subject, left gonadal vein was not identified on either late arterial images or venous phase images (not shown).

View larger version (108K): [in a new window]   Fig. 3A. —31-year-old man with normal preaortic left renal vein with small posterior branch of left renal vein that is difficult to differentiate from lumbar vein or ascending lumbar vein. Venous phase anterior oblique volume-rendered 3D image shows normal preaortic left renal vein with small posterior branch of left renal vein (arrowheads) that is difficult to differentiate from lumbar vein or ascending lumbar vein. This small posterior branch was not opacified during late arterial phase (not shown) and opacified only during venous phase.

View larger version (101K): [in a new window]   Fig. 3B. —31-year-old man with normal preaortic left renal vein with small posterior branch of left renal vein that is difficult to differentiate from lumbar vein or ascending lumbar vein. Venous phase superior volume-rendered 3D image shows small posterior branch of left renal vein coursing posterior to aorta and draining into inferior vena cava (arrowheads).

View larger version (146K): [in a new window]   Fig. 4A. —36-year-old woman with two right renal veins. Late arterial phase anterior reformatted image shows two right renal veins, which are opacified (arrows) and left gonadal vein, which is not. Left adrenal vein is opacified on another late arterial phase image (not shown).

View larger version (137K): [in a new window]   Fig. 4B. —36-year-old woman with two right renal veins. Venous phase anterior reformatted image shows that left gonadal vein (arrowheads) is opacified. Two right renal veins remain well opacified.

View larger version (155K): [in a new window]   Fig. 5A. —51-year-old woman with three right renal veins. Late arterial phase anterior volume-rendered 3D image shows well-opacified right renal vein (large arrow), two right adrenal veins draining closely into left renal vein (arrowheads), and large left gonadal vein (small arrow).

View larger version (156K): [in a new window]   Fig. 5B. —51-year-old woman with three right renal veins. Late arterial phase anterior volume-rendered 3D image obtained slightly posterior to A shows that additional two right renal veins (arrows) are opacified.

View larger version (142K): [in a new window]   Fig. 6A. —29-year-old woman with delayed opacification of left adrenal and gonadal veins. Late arterial phase anterior reformatted image shows well-opacified left renal vein. Left adrenal vein and gonadal vein are not opacified.

View larger version (144K): [in a new window]   Fig. 6B. —29-year-old woman with delayed opacification of left adrenal and gonadal veins. Venous phase anterior reformatted image shows that left adrenal vein (arrowhead) and left gonadal vein (arrow) are opacified and left renal vein remains well opacified.

View larger version (145K): [in a new window]   Fig. 7. —56-year-old man with two left gonadal veins. Late arterial phase anterior volume-rendered 3D image shows that two left gonadal veins (arrows) are opacified. Bilateral renal veins and left adrenal vein (arrowhead) are also opacified.

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