Diagnostic accuracy of CT angiography in evaluation of vascular anatomy in comparison with intraoperative findings an assessment of 392 patients

Abstract

Introduction: Transplantation of kidneys from living related donors is the treatment of choice for patients with end stage renal disease. With lessmorbidity and early recovery,  laparoscopy has become the standard of care for donor nephrectomies. The precise knowledge of vascular anatomy is crucial to a successful outcome. Computed tomography (CT) findings are misleading and less informative in a small number of cases. The reported accuracy of CT angiography in assessing the vascular anatomy is around 85 to 100 %. We did a prospective study to assess the diagnostic accuracy of CT angiography in the evaluation of vascular anatomy in comparison with intra operative findings.Aim:  To assess the accuracy of CT in predicting the anatomy in patients who underwent laparoscopic donor nephrectomy.Materials and methods: 392 patients who underwent laparoscopic donor nephrectomy in our institute between January 2010 and December 2012 were included in our study.Results: CT scan correlated well with the intra operative findings in most of our patients with good sensitivity and specificity. CT interpreted a case of double renal vein as single and a case of circumaortic vein reported on CT was not detected intra operatively. A case of right side early branching was not detected on CT. A case of a retroaortic branch of renal vein was missed on CT scan. The incidental findings detected on CT scan such as calculi, mass and hemangioma or fibroid can be of help in managing the patient after surgery.