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UROSCAN
Year : 2005  |  Volume : 21  |  Issue : 2  |  Page : 130
 

Donor evaluation: CT angiogram or MR angiogram?


Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India

Correspondence Address:
J Chandra Singh
Department of Urology, Christian Medical College,Vellore 632 004, Tamilnadu
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Chandra Singh J, Kekre NK. Donor evaluation: CT angiogram or MR angiogram?. Indian J Urol 2005;21:130

How to cite this URL:
Chandra Singh J, Kekre NK. Donor evaluation: CT angiogram or MR angiogram?. Indian J Urol [serial online] 2005 [cited 2019 Oct 17];21:130. Available from: http://www.indianjurol.com/text.asp?2005/21/2/130/19643


Prospective study comparing three-dimensional computed tomography and magnetic resonance imaging for evaluating the renal vascular anatomy in potential living renal donors.BJU Int. 2005;96:1105-8. Bhatti AA, Chugtai A, Haslam P, Talbot D, Rix DA, Soomro NA.


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This study[1] was designed to prospectively compare the accuracy of multislice CT angiography (CTA) with MR angiography (MRA). As part of workup for donor nephrectomy, both CTA and MRA were done for 31 consecutive prospective kidney donors between July 2001 and December 2003. To ensure accuracy of reporting, the images were independently reported by two radiologists. In cases of discrepancy between the methods, a consensus was arrived at. All 31 subsequently underwent donor nephrectomy. Left laparoscopic donor nephrectomy was done if the vascular anatomy was favourable and right open nephrectomy in others. Including major double vessels, there were 33 arteries and 32 veins. All of them were detected correctly (100%) by CTA; All but one each of the arteries and veins were detected by MRA (97%). Four of the five accessory arteries and one of the three accessory renal veins were missed by MRA but all of them were identified by CTA. The detection of lumbar veins by CTA and MRA was 81 and 41%, respectively and that of left gonadal veins 74 and 46%, respectively.

In a study among 13 patients comparing MRA with DSA, Adamis et al[2] found that all accessory arteries were identified by MRA. However, the venous anatomy was not clearly determined. Israel et al found that the sensitivity and positive predictive value of MRA were 75 and 95%, respectively in correctly identifying the vascular, ureteral and parenchymal anatomy. One procedure had to be converted to open nephrectomy on the basis of complex venous anatomy not prospectively identified on the MR images.[3] Absence of radiation and avoidance of iodinated contrast agents are distinct advantages if equivalent accuracy is established.[4] In a similar study to compare the accuracy of CTA and MRA[5], all patients did not finally undergo nephrectomy. Hence, the findings could only be compared between CTA and MRA. Refinements in MR techniques are being studied and they are likely to yield higher temporal and spatial resolution can be achieved simultaneously.[6] In spite of poorer sensitivity compared to CTA, MRA has an important role to play if CTA is contraindicated.

 
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1.Bhatti AA, Chugtai A, Haslam P, Talbot D, Rix DA, Soomro NA.Prospective study comparing three-dimensional computed tomography and magnetic resonance imaging for evaluating the renal vascular anatomy in potential living renal donors. BJU Int 2005;96:1105-8.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]
2.Adamis MK, Goldszer RC, Pulde MF, Sax EJ, Edelman RR.Renal vasculature in potential renal transplant donors: comparison of MR imaging and digital subtraction angiography. Radiology 1995;197:467-72.  Back to cited text no. 2  [PUBMED]  
3.Israel GM, Lee VS, Edye M, Krinsky GA, Lavelle MT, Diflo T, Weinreb JC. Comprehensive MR imaging in the preoperative evaluation of living donor candidates for laparoscopic nephrectomy: initial experience. Radiology 2002;225:427-32.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]
4.Hussain SM, Kock MC, IJzermans JN, Pattynama PM, Hunink MG, Krestin GP. MR imaging: a "one-stop shop" modality for preoperative evaluation of potential living kidney donors. Radiographics 2003;23:505-20.  Back to cited text no. 4  [PUBMED]  [FULLTEXT]
5.Halpern EJ, Mitchell DG, Wechsler RJ, Outwater EK, Moritz MJ, Wilson GA. Preoperative evaluation of living renal donors: comparison of CT angiography and MR angiography. Radiology 2000;216:434-9.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]
6.Huang Y, Gurr D, Wright GA.Three-dimensional reconstruction of limited-view projections for contrast-enhanced magnetic resonance angiography at high temporal and spatial resolution. Magn Reson Med 2005; [Epub ahead of print]  Back to cited text no. 6    




 

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