Three-dimensional volume-rendered CT angiography of the renal arteries and veins: normal anatomy, variants, and clinical applications.

Abstract

Three-dimensional volume-rendered computed tomographic (CT) angiography represents an increasingly important clinical tool that, in many institutions, is replacing conventional angiography in the depiction of normal vascular anatomy and the diagnosis of vascular disorders. Evaluation of conditions affecting the renal vasculature constitutes a major focus of volume-rendered CT angiography, which has documented utility for demonstrating both arterial and venous disease. Arterial disorders include renal artery stenosis, renal artery aneurysms, and dissection. Venous disorders include splenorenal shunts, thrombosis, and intravascular tumor extension. In addition, volume-rendered CT angiography accurately displays the normal and variant renal vascular anatomy, which is crucial to detect before surgery, especially partial nephrectomy and laparoscopic nephrectomy. CT angiography is also useful in the evaluation of the renal vasculature following renal transplantation. Familiarity with proper CT protocols and data acquisition techniques are crucial for accurate diagnosis.