The Utility of 64 Channel Multidetector CT Angiography for Evaluating the Renal Vascular Anatomy and Possible Variations: a Pictorial Essay

Abstract

The increased use of laparoscopic nephrectomy and nephron-sparing surgery has prompted the need for a more detailed radiological evaluation of the renal vascular anatomy. Multidetector CT angiography is a fast and accurate modality for assessing the precise anatomy of the renal vessels. In this pictorial review, we present the multidetector CT angiography appearances of the normal renal vascular anatomy and a spectrum of various anomalies that require accurate vascular depiction before undergoing surgical treatment.

Evaluation of left renal vein and inferior vena cava variations through routine abdominal multi-slice computed tomography

“…Inferior vena cava variations include double IVC, left IVC, and azygos continuation of the IVC, which occur in 0.2-3%, 0.2-0.5%, and 0.6% of cases, respectively [6,10]. It is crucial to determine the presence of LRV and IVC variations before beginning retroperitoneal surgical interventions, interventional vascular procedures, or donor nephrectomies for transplantation, and the vascular structures and associated abdominal pathologies can be evaluated quickly and reliably by means of multi-slice computed tomography (MSCT) [8]. The purpose of this study is to evaluate the frequency of LRV and IVC variations and the effect of gender on this frequency, as well as the presence of associated abdominal pathologies.…”

A combined variation of the right urogenital veins and bilaterally renal arteries

“…Variations in the right renal vein (up to 30% of individuals) are more often reported as compared to the left renal vein [4,9,16]. Major variants include the dual renal veins: the lower renal vein of double renal veins was draining into the inferior vena cava indirectly via the upper renal vein [8,19] or a single hilar vein splits into 'Y'-shaped 2 components with an accessory renal artery passing through the space between the inferior vena cava and the 2 components of the right renal vein [10].…”

“…The abnormalities in the urogenital artery are frequent, well-described embryological point of view, and so need no further detailed discussion [7,9,15,16]. Briefly, mesonephric arteries are divided into cranial, middle and caudal in embryo: the testicular artery normally originated from the caudal group while the middle group gives rise to the renal arteries from the definitive branches of the urogenital rete arteriosum.…”

“…The normal testicular veins, the renal veins, and the segments of the inferior vena cava into which the testicular veins drain, have a common origin from the foetal subcardinal vein. The right subcardinal vein becomes the main drainage channel and develops into the renal segment of the inferior vena cava, right renal vein and right testicular vein [9,11,12,16]. In this context, variations of the urogenital veins are caused by dysplasia of the subcardinal venous system during embryogenesis.…”

Irrigación Renal: Multiplicidad de Arterias

“…El incremento en el uso de la nefrectomía laparoscópica ha llevado a la necesidad de una evaluación imagenológica detallada de la anatomía vascular renal (Kumar et al, 2010).…”