Renal magnetic resonance angiography in the preoperative detection of supernumerary renal arteries in potential kidney donors.

Abstract

Careful evaluation of the renovascular anatomy in potential living-related kidney donors is essential regarding the presence of accessory renal arteries. Conventional arteriography remains the standard of evidence for delineating the renal arterial supply. We assessed the utility of two-dimensional phase contrast (PC) magnetic resonance angiography (MRA) in the workup of potential living-related renal donors. Thirty-nine patients were examined with conventional arteriography and MRA, which was performed on a 1.5-T system using a two-dimensional PC technique in both coronal and axial planes (repetition time[TR]/echo time [TE] = 39/8.5 msec; flip 60 degrees; matrix 256 x 128; field of view, 28 cm2; 2 excitations; first-order gradient-moment nulling; 7-mm section with 2-mm overlap). The number of hilar and polar supernumerary renal arteries was determined. Hilar supernumerary arteries were classified as co-dominant if they were similar in size to the ipsilateral main renal artery. Conventional arteriography identified 78 dominant and 13 supernumerary (3 co-dominant, 10 accessory) renal arteries. Magnetic resonance angiography identified the proximal 35 mm of all 78 dominant and the 3 co-dominant renal arteries. Of the remaining ten (7 polar and 3 hilar) accessory vessels, only four were correctly identified with MRA. The high error rate (60%) suggests that two-dimensional PC MRA, as implemented, should not be used in the preoperative evaluation of potential renal donors.