COMPARISON OF SPIRAL COMPUTED TOMOGRAPHY RENAL ANGIOGRAPHY VERSUS DIGITAL SUBTRACTION RENAL ANGIOGRAPHY IN PRE-OPERATIVE KIDNEY DONOR EVALUATION

COMPARISON OF SPIRAL COMPUTED TOMOGRAPHY RENAL ANGIOGRAPHY VERSUS DIGITAL SUBTRACTION RENAL ANGIOGRAPHY IN PRE-OPERATIVE KIDNEY DONOR EVALUATION
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Title:COMPARISON OF SPIRAL COMPUTED TOMOGRAPHY RENAL ANGIOGRAPHY VERSUS DIGITAL SUBTRACTION RENAL ANGIOGRAPHY IN PRE-OPERATIVE KIDNEY DONOR EVALUATION
Author/Abstract:
Raul N. Sancho, MD; Pavio L. Buac, MD and Nelson A. Patron, MD

Department of Urology, National Kidney and Transplant Institute

Objectives: At the National Kidney and Transplant Institute (NKTI), the conventional Seldinger technique renal arteriogram with Digital Subtraction Angiography (DSA) has been the standard for the evaluation of the renal vasculature of potential kidney donors. The acquisition of the Siemens Somatom Emotion Spiral Computed Tomography (CT) with software capable of multiplanar 3-dimensional imaging has led to the evaluation of its role as a possible alternative or replacement for DSA. The accuracy of each modality in identifying the actual renal vessel anatomy is determined using intra-operative findings. Materials and Methods: Between January and September 2001, a total of 116 potential kidney donors divided into two groups, underwent angiography at NKTI (59 DSA, 57 Spiral CT). The results were then compared with the actual intraoperative findings using Kappa test. The accuracy rate for each modality was also computed. Results: There was no statistical difference between the two modalities as to the sensitivity rate and the overall agreement with the intra-operative findings. Errors in detection by CT angiogram, particularly the missed pre-hilar or accessory arteries, were found to be comparable with the conventional DSA. Conclusion: The spiral CT renal angiography appears to be as accurate as the conventional DSA in detecting the actual renal vasculature. It has the potential to replace the conventional DSA being less invasive, less expensive and equally reliable in the evaluation of potenital kidneys donors.

Key words: kidney donor, spiral computed tomography (CT) angiography, digital subtraction angiography (DSA), renal vasculature.
 
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