Learning objectives
- To highlight the usefulness of CT-angiography in the detection of anatomical variants in renal vasculature.
- To review all anatomical variants of renal vascularization,
so as their correct nomenclature according to recent published articles.
- To describe the clinical importance of such variants and their usefulness in planification of surgery or interventional procedures.
Background
Vast majority of the popoulation has one renal artery for each kidney,
as described in almost every atlas of human anatomy,
which divides into two or more branches at hilum.
This pattern isn´t free of variations.
Double or triple renal arteries have been described,
so as polar arteries with aortic,
iliac or even mesenteric origins.
There is an incidence of 20-50% for multiple renal arteries.
These anatomical variants are explained by renal embriology.
The kidneys begin their embryogenesis at pelvis,
appearing for the first time...
Findings and procedure details
Renal arteries can easily be identified on CT-angiography,
even lesser arteries like segmentary branches can also be seen.
Despite detection of vessels inferior to 2mm is limited,
CT-angiography can reach 100% sensitivity using 3D reconstructions and MIP to identify main renal arteries.
Furthermore,
3D and MIP have demonstrated 100% sensitiviy in detection of polar arteries.
Multiple renal arteries constitute the most common anatomical variant of the renal vasculature according to its clinical relevance,
and they are presente in barely 30% of the population.
Multiple renal...
Conclusion
CT-angriography has demonstrated its usefulness.
It provides accurate evaluation of renal vasculature,
so as its different anatomical variants,
from an efficient,
rapid and safety way compared to conventional angiography.
A correct knowledge of the several anatomical variants of renal arteries so as their typification,
has big relevance at the radiological report prior to surgical or interventional procedures.
References
Liu PS,
Platt JF.
CT Angiography of the Renal Circulation.
Radiol Clin N Am.
2010; 48 (2): 347-65.
Olave E,
Henríquez J,
Puelma F,
Cruzat C,
Soto A.
Arterias Renales Múltipes.
Int J Morphol.
2007; 25(4): 927-30.
Saldarriaga B,
Pinto SA,
Ballesteros LE.
Morphlogical Expression of the Renal Artery.
A Direct Anatomical Study in a Colombian Half-caste Population.
Int.
J Morphol.
2008; 26 (1):31-8.
Garti I.,
Nissenkorn I.,
Lerner M.
Common origin of inferior mesenteric and main renal artery.
Eur Urol.1986;12 (3): 215-6.
Sampaio FJ,...