Single-phase 16-slice multidetector computed tomographic angiography in the evaluation of the venous system in potential laparoscopic renal donors.

摘要

OBJECTIVE: Our objective was to assess the efficacy of single-arterial-phase, 16-slice multidetector computed tomographic (16-MDCT) angiography in the evaluation of both the renal arterial and venous systems in prospective renal donors with surgical (laparoscopic) correlation. METHODS: Fifty-one consecutive renal donors (age range, 20-62 years; 12 men and 39 women) underwent 16-MDCT angiography followed by laparoscopic donor nephrectomy. Approval from institutional review board was obtained with waiver of consent. The arterial-phase image data set was reviewed independently by 2 abdominal radiologists for the number of renal arteries and veins, anomalies, and degree of opacification of the renal veins. Computed tomographic angiography results were compared with the surgical findings. Interobserver agreement was assessed using kappa statistics. RESULTS: The sensitivity, specificity, and accuracy for identifying the number of renal veins in the arterial phase on 16-MDCT angiography were 96.3%, 96.07%, and 96.2% for reviewer 1 and 94.44%, 94.11%, and 94.3% for reviewer 2, respectively. Both reviewers correctly identified all venous anomalies and had substantial interobserver agreement (kappa coefficient = 0.68). CONCLUSIONS: A single-arterial-phase image data set is sufficient for evaluation of both the renal arterial and venous anatomy in potential renal donors before laparoscopic nephrectomy. Venous-phase acquisition is not necessary, thereby substantially reducing the radiation burden on the donor.