Preoperative Multi-Detector Computed Tomography in Kidney Donors; Quantitative Data Report from Operation Rooms

Abstract

Background: Multi-detector computed tomography (MDCT) angiography is a non-invasive imaging modality, and is replacing the invasive conventional angiography in preoperative studies of vascular anatomy. Objectives: To determine the accuracy of MDCT in diagnosis of the renal arterial and venous anatomy, urinary collecting system and kidney anatomy itself in living kidney donors. Patients and Methods: In the present prospective single-center study, 134 potential kidney donors (age: 25.65 ± 3.37 years) underwent MDCT and MDCT angiography in a single center (Aug 2012 - Oct 2013). The bolus tracking method was used. Arterial and venous anatomical variations and kidney size were assessed and compared with the surgical findings. Results: MDCT angiography revealed renal arteries, their branching with 100% sensitivity, specificity, positive and negative predictive values. In addition, the sensitivity, specificity, positive predictive value and negative predictive value for MDCT angiography were 85.71%, 100%, 100% and 99.14%, respectively, in diagnosis of venous branching pattern. There is direct linear correlation between MDCT angiography and surgical findings in measuring arterial length and diameter, and kidney size (All P values < 0.001). Only one patient had ureteral duplication. Conclusion: MDCT determines the renal vascular and urinary collecting system anatomy, and kidney characteristics with almost 100% accuracy in kidney donors.