Gadolinium-enhanced MR Angiography in Preoperative Renal Vasculature Evaluation of Living Renal Transplantation: Comparison with Conventional Angiography

Kim, Hwan; Rim, Joo Hyun; Park, Bong Hee; Jeong, Young Beom; Kim, Young Gon

Abstract

PURPOSE: This study evaluated the accuracy of three-dimensional gadolinium-enhanced MR angiography (Gd-MRA) in the preoperative evaluation of living renal transplant donors (LRTDs) for visualizing the renal vascular anatomy, with an emphasis on identifying the number of renal arteries and veins and the presence of small branch anomalies.
MATERIALS AND METHODS
Between April 1999 and October 2003, a total of 42 LRTDs were evaluated with conventional renal angiography (CRA) or three-dimensional Gd-MRA. The three-dimensional Gd-MRA was performed in 20 cases and CRA in 22. All candidates then underwent a donor nephrectomy. The intraoperative findings of the renal vessels were compared between the CRA and three-dimensional Gd-MRA, and the complications and side effects also examined.
RESULTS
The overall accuracies for predicting the numbers and abnormalities of renal arteries and veins by comparing the intraoperative findings were 85 and 95% for the three-dimensional Gd-MRA, and 91 and 98% for the CRA. The three-dimensional Gd-MRA missed 3 accessory renal arteries, while the CRA missed 1, as well as 1 renal artery bifurcation. There were three complications; one contrast anaphylaxis and two hematomas at the puncture site, in the 22 CRA cases, but there were no significant complications in the three-dimensional Gd-MRA.
CONCLUSIONS
Three-dimensional Gd-MRA appears to be as accurate as CRA for visualizing the renal vascular anatomy in the preoperative assessment of potential LRTDs. Three-dimensional Gd-MRA is a noninvasive and noncontrast technique, which would be a good alternative to CRA for assessing potential LRTDs.