Role of Arterial Phase Imaging In Assessing Venous Anatomy and Venous Anomalies in Multi-Detector Row CT Angiography of Living Related Renal Donors

Abstract

Objective: To determine the role of arterial phase imaging in assessing venous anatomy and venous anomalies in multi-detector row CT angiography of living related renal donors

Methodology: This retrospective study was conducted in the Radiology Department of Pakistan Kidney and Liver Institute and Research Center, Lahore (PKLI & RC). After institutional review board approval, we evaluated MDCT images of 56 consecutive renal donors. Two consultant radiologists independently assessed the renal venous anatomy on the arterial and venous phase images. The sensitivity of detection of accessory renal veins, gonadal veins and lumbar veins was determined. Interobserver agreement was assessed using Cohen’s kappa.

Results: Both radiologists characterized renal venous anatomy variants correctly on arterial and venous phases. Circumaortic left renal vein (n=4) and retro aortic left renal vein (n=4). The sensitivity of detection of the accessory renal veins, right gonadal and left lumbar veins on arterial phase images was 97% each whereas that for left gonadal vein was 100%. Cohen’s kappa showed a substantial inter-observer agreement (kappa coefficient: 0.9; p<0.005).

Conclusion: The renal venous anatomy, including the detection of anatomic variations, can be assessed on arterial phase MDCT images alone in renal donors, excluding the venous phase from the protocol in renal donor evaluation.