Association of Congenital Left Renal Vein Anomalies and Unexplained Hematuria: Multidetector Computed Tomography Findings

Objectives: To investigate whether congenital renal vein anomalies are involved in the etiology of hematuria by analyzing abdominal multidetector computed tomography (MDCT) results. Methods: Six hundred and eighty patients undergoing MDCT for various abdominal pathologies in whom possible causes of hematuria were excluded were retrospectively assessed in terms of left renal vein anomalies, such as circumaortic left renal vein (CLRV), retroaortic left renal vein (RLRV) and multiple renal vein (MRV). Patients with CLRV, RLRV or MRV and patients with normal left renal veins were compared in terms of the presence of hematuria. Results: Left renal vein anomalies were detected in 100 patients (14.7%). RLRV, CLRV and MRV were identified in 5.4, 2.5 and 6.8% of patients, respectively. Hematuria was determined in 8.1% of patients with an RLRV anomaly and in 10.5% of patients with no RLRV anomaly (p = 0.633). Hematuria was detected in 23.5% of patients with a CLRV anomaly and 10.1% of those without (p = 0.074), and in 21.7% of patients with an MRV anomaly and 9.6% of those without (p = 0.009). Conclusions: In addition to increasing risk of complication during retroperitoneal surgery, numeric congenital renal vein anomalies are also significant in terms of leading to clinical symptoms such as hematuria.

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Evaluation of left renal vein entrapment using multidetector computed tomography

Acta Radiologica ◽

10.1258/ar.2012.120355 ◽

2013 ◽

Vol 54 (2) ◽

pp. 144-148 ◽

Cited By ~ 17

Author(s):

Ahmet K Poyraz ◽

Fatih Firdolas ◽

Mehmet R Onur ◽

Ercan Kocakoc

Keyword(s):

Computed Tomography ◽

Multidetector Computed Tomography ◽

Renal Vein ◽

Left Renal Vein

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Mesoaortic compression of left renal vein revealed by multidetector computed tomography: nutcracker syndrome

Emergency Medicine Journal ◽

10.1136/emj.2006.040741 ◽

2007 ◽

Vol 24 (9) ◽

pp. 636-636 ◽

Cited By ~ 4

Author(s):

W.-J. Yang ◽

Y.-P. Liu ◽

F.-S. Yang

Keyword(s):

Computed Tomography ◽

Multidetector Computed Tomography ◽

Renal Vein ◽

Left Renal Vein ◽

Nutcracker Syndrome

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Nutcracker or left renal vein compression phenomenon: multidetector computed tomography findings and clinical significance

European Radiology ◽

10.1007/s00330-005-2688-y ◽

2005 ◽

Vol 15 (8) ◽

pp. 1745-1751 ◽

Cited By ~ 41

Author(s):

Hug Cuéllar i Calàbria ◽

Sergi Quiroga Gómez ◽

Carmen Sebastià Cerqueda ◽

Rosa Boyé de la Presa ◽

Américo Miranda ◽

...

Keyword(s):

Computed Tomography ◽

Multidetector Computed Tomography ◽

Clinical Significance ◽

Renal Vein ◽

Left Renal Vein

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Retroaortic left renal vein: multidetector computed tomography angiography findings and its clinical importance

Acta Radiologica ◽

10.1080/02841850701244755 ◽

2007 ◽

Vol 48 (3) ◽

pp. 355-360 ◽

Cited By ~ 38

Author(s):

B. Karaman ◽

M. Koplay ◽

E. Özturk ◽

C. C. Basekim ◽

H. Ogul ◽

...

Keyword(s):

Computed Tomography ◽

Multidetector Computed Tomography ◽

Computed Tomography Angiography ◽

Renal Vein ◽

Left Renal Vein ◽

Clinical Importance ◽

Multidetector Computed Tomography Angiography

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Prevalence of Congenital Anomalies of the Inferior Vena Cava: CT Assessment in Thai Patients

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.09.12629 ◽

2021 ◽

Vol 104 (9) ◽

pp. 1459-1464

Keyword(s):

Inferior Vena Cava ◽

Renal Vein ◽

Inferior Vena ◽

Left Renal Vein ◽

Vena Cava ◽

Renal Veins ◽

Retrocaval Ureter ◽

Radiology Reports ◽

Contrast Enhanced ◽

Study Population

Objective: To determine the prevalence of inferior vena cava (IVC) anomalies in Thai patients who underwent contrast-enhanced computed tomography (CT) of the abdomen. Materials and Methods: Two radiologists retrospectively and independently reviewed the contrast-enhanced abdominal CT examinations in 1,429 Thai patients between August 1, 2018 and January 25, 2019 who met the inclusion criteria. Patients were included, if (a) their CT showed well visualized IVC, renal veins, and right ureter that were not obliterated by tumor, cyst, fluid collection, or intraperitoneal free fluid, (b) they had not undergone previous abdominal surgery that altered anatomical configuration of the IVC, renal veins, and right ureter. The presence of all IVC anomalies were recorded. Results: Among the 1,429 studied patients, 678 were male (47.4%) and 751 were female (52.6%). The prevalence of IVC anomalies was 3.5%. Five types of IVC anomalies were presented. The most common was circumaortic left renal vein in 24 patients or 48.0% of all IVC anomalies and 1.7% of the study population, followed by retroaortic left renal vein in 15 patients or 30.0 % of all IVC anomalies and 1.0% of the study population. Other IVC anomalies included double IVC, left IVC, and retrocaval ureter at 0.5%, 0.2%, and 0.1% of the study population, respectively. Conclusion: The prevalence of IVC anomalies in the present study differed from the previous studies conducted in other countries, which may be attributable to differences in race and ethnicity. Awareness of these anomalies is essential when evaluating routine CT examinations in asymptomatic patients. Their presence should be carefully noted in radiology reports to avoid anomaly-related complications. Keywords: Prevalence; IVC anomalies; Circumaortic left renal vein; Retroaortic left renal vein; Double IVC; Left IVC; Retrocaval ureter

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Nutcracker Syndrome: A Rare Cause of Hematuria

The Scientific World JOURNAL ◽

10.1100/tsw.2006.144 ◽

2006 ◽

Vol 6 ◽

pp. 745-746 ◽

Cited By ~ 6

Author(s):

Emmanuel C. Gorospe ◽

Michael O. Aigbe

Keyword(s):

Superior Mesenteric Artery ◽

Renal Vein ◽

Mesenteric Artery ◽

Left Renal Vein ◽

Nutcracker Syndrome ◽

Renal Veins ◽

Collecting System

Nutcracker syndrome is the compression of the left renal vein between the aorta and superior mesenteric artery. It is a rare cause of hematuria which results from the rupture of congested renal veins into the collecting system.

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The Value of Preprocedure Computed Tomography for Planning Insertion of Inferior Vena Cava Filters

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2009.11.006 ◽

2010 ◽

Vol 61 (4) ◽

pp. 223-229 ◽

Cited By ~ 5

Author(s):

Jeffrey D. Jaskolka ◽

Rachel P.W. Kwok ◽

Sara H. Gray ◽

Hamid R. Mojibian

Keyword(s):

Computed Tomography ◽

Inferior Vena Cava ◽

Renal Vein ◽

Inferior Vena ◽

Vena Cava ◽

Reference Standards ◽

Ivc Filter ◽

Renal Veins ◽

Lumbar Vertebral Body ◽

The Mean

Purpose To determine if valuable information could be obtained from abdominal computed tomography (CT) performed before insertion of an inferior vena cava (IVC) filter. Materials and Methods A retrospective review was performed on IVC filter insertions with a CT performed before the procedure. Cavagram and CT were compared for renal vein and IVC anatomy, the diameter of the IVC, and the prevalence of iliocaval thrombus. Correlations were assessed among 3 reference standards for measuring the IVC at cavography. Results The mean IVC diameter was 23.0 mm on CT. On cavagram the mean IVC diameter was assessed by using 3 reference standards: 20.7 mm, with the catheter tip as a reference; 26.9 mm, with a radiopaque ruler; and 23.4 mm, by using a lumbar vertebral body. There was good correlation among the 3 measures of IVC diameter (Pearson's r = 0.75, P < .0001) but moderate correlation with CT (r = 0.36–0.56, P < .001). The sensitivity of cavagram for detecting retroaortic and circumaortic renal veins was 40% and 0%, respectively. Nineteen accessory renal veins (12.8%) were not seen by cavagram. Thirteen patients (8.8%) had iliocaval thrombus on cavagram, of which 12 (92.3%) were not previously detected by CT. Conclusions CT is more sensitive than cavagram for detection of renal vein variants and the level of the lowest renal vein. Therefore, if available, the CT should be reviewed before placement of an IVC filter to optimize positioning. Cavagram remains the criterion standard for detection of iliocaval thrombosis and is necessary before IVC filter insertion.

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Vascular anomalies in patients undergoing retroperitoneal lymph node dissection.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.4_suppl.382 ◽

2014 ◽

Vol 32 (4_suppl) ◽

pp. 382-382

Author(s):

Andrea K. Thissen ◽

Daniel Porres ◽

David J. K. P. Pfister ◽

Charlotte Piper ◽

Axel Heidenreich

Keyword(s):

Lymph Node ◽

Renal Vein ◽

Left Renal Vein ◽

Germ Cell Tumors ◽

Vena Cava ◽

Vascular Anomalies ◽

Retroperitoneal Lymph Node Dissection ◽

Testis Cancer ◽

Renal Veins ◽

Retroperitoneal Lymph Node

382 Background: Anomalies of the renal vessels usually are clinically silent and might depicted during CT scanning of the abdomen for staging purposes of urological malignancies. Awareness of these rare anomalies is crucial especially in patients undergoing staging for germ cell tumors in order to avoid overstaging and unnecessary therapy. We report on the incidence of renal vessel anomalies in an unselected group of patients undergoing retroperitoneal lymph node dissection (RPLND) for testis cancer. Methods: 245 patients with testicular germ cell tumors underwent primary or secondary RPLND following inductive chemotherapy. Prior to RPLND, all patients underwent abdominal staging by CT scans or by MRI in selected cases. CT scans were reviewed with regard to the detection of vascular anomalies of the vena cava inf., renal veins, renal arteries, and iliac vessels. CT findings were correlated with intraoperative findings. Results: Overall, vascular anomalies were encountered in 39 patients (15.9%): retroaortic left renal vein in 10 (4.1%), circumaortic left renal vein in two (0.8%), reduplication of the common iliac vein in one (0.4%), accessory renal arteries in 14 (5.7%), thrombosis of the inferior vena cava in 12 (4.9%) patients with IIC disease. Anomalies of the renal vein were detected in 10 out of 12 (83%), in two cases venous anomalies were falsely diagnosed as lymph node disease in stage I NSGCT. All arterial anomalies were identified preoperatively. CT scan identified caval thrombosis in only eight cases (68%), four cases were identified by an additional MRI of the abdomen. Conclusions: Vascular anomalies are frequently encountered in patients with RPLND for testis cancer and have to be acknowledged during surgery even with negative imaging studies. Retroaortic renal veins represent a potential pitfall of CT imaging resulting in unnecessary therapy; it should be considered in pts with CT suspicious lymph nodes caudal to the renal hilus. IVC thrombosis is associated with advanced disease and is best diagnosed by MRI of the abdomen.

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Nutcracker Syndrome Complicated by Left Renal Vein Thrombosis

Case Reports in Urology ◽

10.1155/2013/168057 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Faouzi Mallat ◽

Wissem Hmida ◽

Mehdi Jaidane ◽

Nadia Mama ◽

Faouzi Mosbah

Keyword(s):

Computed Tomography ◽

Computed Tomography Angiography ◽

Renal Vein ◽

Left Renal Vein ◽

Renal Vein Thrombosis ◽

Flank Pain ◽

Complete Disappearance ◽

Nutcracker Syndrome ◽

Rare Entity ◽

Vein Thrombosis

Isolated renal vein thrombosis is a rare entity. We present a patient whose complaint of flank pain led to the diagnosis of a renal vein thrombosis. In this case, abdominal computed tomography angiography was helpful in diagnosing the nutcracker syndrome complicated by the renal vein thrombosis. Anticoagulation was started and three weeks later, CTA showed complete disappearance of the renal vein thrombosis. To treat the Nutcracker syndrome, we proposed left renal vein transposition that the patient consented to.

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