Helical CT in renal transplantation: Normal findings and early and late complications

Over a 5-year period, 346 helical computed tomographic (CT) studies were pe rformed in renal transplant recipients. Helical CT proved useful in this co ntext by depicting parenchymal, perirenal, renal sinus, pyeloureteral, and vascular complications in great detail. CT often delineates fluid collectio ns and their anatomic relationship to adjacent structures better than ultra sonography (US), particularly in obese patients. T-guided puncture and drai nage can be performed in cases in which US is deemed inadequate. CT angiogr aphy can depict arterial diseases such as stenosis, thrombosis, arterioveno us fistulas, aneurysms, and pseudoaneurysms in the graft artery and in the recipient iliac arterial system, thereby obviating conventional angiography in some cases. Helical CT with three-dimensional image reformatting allows accurate imaging of the entire course of ureteral and periureteral disease s (eg, hydronephrosis, ureteral leak and stricture, pyeloureteral obstructi on). CT can be used in the confirmation and staging of malignancies of the renal parenchyma and urothelium. It is also helpful in evaluating associate d disease in the native kidneys, acute and chronic rejection, graft emboliz ation, and end-stage disease. Although US and nuclear medicine examination are the imaging modalities of choice in renal transplantation, helical CT i s a valuable alternative when these techniques are inconclusive.