MR angiography and preoperative evaluation for laparoscopic donor nephrectomy

Abstract

Objective: The purpose of our study was to evaluate the effectiveness of gadolinium-enhanced MR imaging in imaging arterial, venous, and ureteric anatomy in a group of potential laparoscopic renal donors and to compare our findings with those established at surgery.

Subjects and methods: Sixty-four consecutive patients underwent successful laparoscopic donor nephrectomy. Imaging of the kidneys was performed before surgery with MR imaging and breath-hold three-dimensional gadolinium-enhanced MR angiography. All studies were reviewed prospectively by one of two attending radiologists. Results were compared with findings at the time of laparoscopic nephrectomy.

Results: Of the 64 patients, MR imaging and MR angiography identified 30 patients with normal arterial, venous, and ureteric anatomy, and concordance was found at surgery in 29 of these patients. Vascular anomalies were depicted on MR imaging in 34 patients, with complete concordance at surgery in 29 patients. The use of MR angiography for revealing arterial anomalies had a sensitivity of 89.4%, specificity of 94.1%, and accuracy of 90.6%. For venous anomalies, there was a sensitivity of 98.3%, specificity of 100%, and accuracy of 98.4%. No important utereric anomalies were identified at surgery or on MR imaging.

Conclusion: Renal MR imaging and gadolinium-enhanced MR angiography provide a safe, accurate, and minimally invasive means of comprehensive assessment of the potential living renal donor.