scholarly journals Computed tomography identified factors that preclude living kidney donation

2018 ◽  
Vol 12 (8) ◽  
Author(s):  
Katerina Mastrocostas ◽  
Christina M. Chingkoe ◽  
Kenneth T. Pace ◽  
Joseph J. Barfett ◽  
Anish Kirpalani ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Critical Role ◽  
Vascular Anatomy ◽  
Preoperative Assessment ◽  
Renal Parenchyma ◽  
Renal Infarction ◽  
Large Area ◽  
Renal Vasculature ◽  
Renal Abnormalities ◽  
Collecting System

Introduction: The purpose of this study was to determine the variety and prevalence of renal and non-renal abnormalities detected on multidetector computed tomography (MDCT) that precluded patients from donating a kidney.Methods: Institutional review board approval was obtained and the requirement for informed consent was waived. A retrospective, single-centre review of 701 patients (444 female, 257 male; age range 18–86 years; mean age 43.2±11.9 years) that underwent renal donor protocol MDCT was conducted. A systematic review of the CT report, records from multidisciplinary renal transplantation rounds, and electronic medical records was performed to determine which patients were approved or declined as live renal donors. If declined as a donor, CT-identified reasons were categorized as abnormalities of renal vasculature, renal parenchyma, collecting system, or extra-renal.Results: A total of 81 patients were excluded as renal donors on the basis of CT findings. Abnormalities of the collecting system accounted for the most frequent cause of exclusion (n=41), with asymptomatic renal calculi being detected in 39 patients. Complex vascular anatomy and vascular abnormalities resulted in the exclusion of 29 patients. Supernumerary arteries and early arterial branching resulted in the exclusion of 20 patients, while renal vein anomalies leading to exclusion were uncommon (n=2). Abnormalities of renal parenchyma resulted in the exclusion of nine patients. Three patients were diagnosed with autosomal dominant polycystic kidney disease, two patients had renal cell carcinoma, and two patients had areas of cortical scarring. A complex cystic lesion requiring surveillance imaging was encountered in one patient and a large area of renal infarction related to prior adrenalectomy was demonstrated in one patient. Extra-renal abnormalities leading to exclusion were limited to two patients with pulmonary nodules.Conclusions: MDCT plays a critical role in the preoperative assessment of potential renal donors by identifying contraindications to donor nephrectomy and providing accurate vascular mapping. This study is anticipated to be informative for those involved in the workup of potential living renal donors by quantifying the incidence and reasons for donor exclusion identified on CT.

scholarly journals Preoperative Assessment of Vascular Anatomy by Multidetector Computed Tomography Before Laparoscopic Colectomy for Transverse Colon Cancer: Report of a Case

2015 ◽  
Vol 100 (2) ◽  
pp. 208-212 ◽  
Author(s):  
Aya Kawamoto ◽  
Yasuhiro Inoue ◽  
Masato Okigami ◽  
Hiromi Yasuda ◽  
Yoshinaga Okugawa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Colon Cancer ◽  
Lymph Node ◽  
Laparoscopic Surgery ◽  
Lymph Node Dissection ◽  
Transverse Colon ◽  
Vascular Anatomy ◽  
Preoperative Assessment ◽  
Transverse Colon Cancer ◽  
Node Dissection

Although the safety of laparoscopic surgery for colon cancer has been reported in many randomized controlled trials, concerns about the difficulty of surgery for transverse colon cancer has not been fully resolved, mainly because of the variation in the vascular anatomy of mesenteric vessels, which leads to difficulty in determining the optimal operative procedure and the extent of lymph node dissection. We present the case of a patient with transverse colon cancer who underwent laparoscopic surgery after preoperative assessment using a combination of endoscopic clipping and three-dimensional computed tomography angiography (3DCTA). A 68-year-old man was diagnosed with transverse colon cancer, and laparoscopic surgery has been planned. 3DCTA showed right-middle and left-middle colic arteries arising independently from the superior mesenteric artery. The relationship between the clip and vessels showed that the right-middle colic artery was the feeding artery of the tumor. Operative findings were consistent with 3DCTA findings, and transverse colectomy with lymph node dissection was successfully performed.

scholarly journals Comparison between C-arm cone beam computed tomography and interventional angiography in transarterial chemoembolization of hepatocellular carcinoma

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Ibraheim Ahmed Diab ◽  
Shaimaa Abdel-hamid Hassanein ◽  
Hala Hafez Mohamed
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Cone Beam Computed Tomography ◽  
Vascular Anatomy ◽  
Cone Beam ◽  
Focal Lesion ◽  
Focal Lesions ◽  
Conventional Angiography ◽  
Interventional Angiography ◽  
Cross Sectional

Abstract Background Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy of adults. One of the established treatment procedures performed worldwide for HCC is transcatheter arterial chemoembolization (TACE). By using conventional angiography in TACE, we can detect and identify the vascular anatomy of the liver through obtaining 2D images. Recently C-arm cone beam computed tomography (CBCT) is introduced for obtaining cross-sectional and three-dimensional (3D) images for better visualization of small tumors and their feeding arteries. Results The number of detected focal lesions by angiography was 51 compared to 87 focal lesion detected by CBCT; of those, 45 and 77 were active lesions by both procedures respectively. For lesions, less than 1 cm CBCT detected 23 lesions while angiography detected only one lesion. Angiography detected 87 feeding arterial branch while cone beam CT-HA detected 130 branches to the same number of target lesion. Feeder tractability and confidence were better by CBCT. Conclusion CBCT is superior to angiography in tumor detectability, detection of lesions less than 1 cm, feeder detection, and feeder traction; however, conventional angiography and DSA are irreplaceable. Thus, combination of CBCT with angiography during TACE produces better results and less complication.

Appearance of renal infarction on computed tomography

1983 ◽  
Vol 7 (3) ◽  
pp. 181-187 ◽  
Author(s):  
Ronald D. Harris ◽  
Stephen Dorros ◽  
F.William Scheible
Keyword(s):  
Computed Tomography ◽  
Renal Infarction

Factitious Hematuria With Underlying Renal Abnormalities

PEDIATRICS ◽  
1988 ◽  
Vol 82 (3) ◽  
pp. 377-379
Author(s):  
RICHARD F. SALMON ◽  
BILLY S. ARANT ◽  
MICHEL G. BAUM ◽  
RONALD J. HOGG
Keyword(s):  
Vesicoureteric Reflux ◽  
Term Pregnancy ◽  
Gross Hematuria ◽  
Persistent Symptoms ◽  
History Of ◽  
Appropriate Therapy ◽  
Complete Duplication ◽  
Renal Abnormalities ◽  
Recurrent Hematuria ◽  
Collecting System

Factitious hematuria is a well-described cause of hematuria in adult patients but is rarely seen or considered in children.1-6 In this article, a 5-year-old girl with a history of gross hematuria with more than one pathologic explanation for recurrent hematuria is described. Because of persistent symptoms despite appropriate therapy, a factitious cause was considered. CASE REPORT The patient was the healthy product of the uncomplicated full-term pregnancy of an unmarried woman who reared the child in the home of her mother and sister. The diagnosis of urinary tract infection was made first at 2 years of age. In subsequent radiographic studies, two normal kidneys were identified, with complete duplication of the left collecting system and bilateral grade 2 vesicoureteric reflux.

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