Intravenous digital subtraction angiography and helical computed tomography in evaluation of living renal donors

Objectives: The present study was carried out to evaluate the accuracy of h elical computed tomography (CT) and intravenous digital subtraction angiogr aphy (IV-DSA) on anatomical assessment of renal vasculature for living rena l donors. Methods: Forty-two healthy potential renal donors were prospectively evalua ted and 35 subsequently underwent donor nephrectomy after helical CT and IV -DSA evaluation. The vascular and non-vascular findings were compared betwe en the findings on helical CT, IV-DSA and surgery. Results: Ten prehilar branches and five accessory renal arteries were found at nephrectomy. Overall, operative findings agreed with the findings by IV -DSA in 89% and by helical CT in 83%. In delineating accessory arteries, IV -DSA had a sensitivity of 60% and specificity of 97%, whereas helical CT ha d a sensitivity of 40% and specificity of 100%. In delineating prehilar bra nches, IV-DSA had a sensitivity of 90% and specificity of 100%, whereas hel ical CT had a sensitivity of 70% and specificity of 100%. Accessory arterie s and prehilar branches that were not detected by helical CT or IV-DSA, wer e less than 2 mm in diameter and did not require vascular reconstruction. R enal veins were delineated in 63% by IV-DSA, whereas they were clearly imag ed by helical CT in all cases, including a case with a circumaortic renal v ein. Non-vascular findings were obtained in 64% by helical CT, including tw o renal tumors. None of these findings were obtained by IV-DSA. Conclusion: Helical CT and IV-DSA provide comparably sufficient information on renal artery vasculature. However, helical CT provides significantly mo re information on venous and nonvascular findings as a single-imaging modal ity.