Fleury Nicolas, Vallée Jean-Paul, Hadaya Karine, Bühler Léo, Martin Pierre-Yves, Iselin Christophe E
Division of Urologic Surgery, Geneva University Hospital, Rue Micheli-du-Crest 24, CH-1211 Geneva 14, Switzerland.
Urol Int. 2010;84(1):56-60. doi: 10.1159/000273467. Epub 2010 Feb 17.
Planification of living donor nephrectomy requires exact knowledge of the renal vascular architecture because of the high prevalence of anatomical variants. After magnetic resonance angiography (MRA) challenged CT angiography for preoperative assessment over the last years, we revisit in this study the reliability of MRA as the sole preoperative assessment for living donor nephrectomy.
We compared the radiological findings of MRA performed as the sole radiological procedure in 44 living kidney donors with perioperative anatomy to verify its sensitivity and to validate its systematic use in the preoperative assessment for living donor nephrectomy.
22 anatomical variants were found in 16 patients (16/44 = 36%). In 4 patients, a polar artery (3 superior, 1 inferior) was not seen by MRA and was detected during surgery (open nephrectomy). Supposing the anatomical variants it described on the opposite side of the nephrectomy are real, sensitivity of this technique in this series is 40/44 (91%) for arterial and 100% for venous imaging.
MRA as the sole radiological preoperative assessment performed by a single radiologist with specific expertise and preoperatively reviewed with the harvesting surgeon has been validated as the sole radiological preoperative assessment for living donor nephrectomy at our institution.
由于解剖变异的高发生率，活体供肾肾切除术的规划需要对肾血管结构有准确的了解。在过去几年磁共振血管造影（MRA）对CT血管造影在术前评估方面发起挑战之后，我们在本研究中重新审视MRA作为活体供肾肾切除术唯一术前评估的可靠性。
我们将44例活体肾供体中仅作为唯一影像学检查进行的MRA的影像学结果与围手术期解剖结构进行比较，以验证其敏感性并证实其在活体供肾肾切除术术前评估中的系统应用。
16例患者（16/44 = 36%）中发现22处解剖变异。4例患者中，MRA未显示出极动脉（3例上极动脉，1例下极动脉），而在手术（开放肾切除术）中被发现。假设其在肾切除术对侧描述的解剖变异是真实的，该技术在本系列中对动脉成像的敏感性为40/44（91%），对静脉成像的敏感性为100%。
在我们机构，由具有特定专业知识的单一放射科医生进行的MRA作为唯一的术前影像学评估，并在术前与切取手术医生共同审核，已被确认为活体供肾肾切除术唯一的术前影像学评估。
