Jaafar Mzhda Sahib, Mohammed Naser Abdullah, Said Shakhawan Hama Amin, Bapir Rawa, Hiwa Dilan S, Abdalla Berun A, Kakamad Fahmi H
College of Medicine, University of Sulaimani, Sulaymaniyah, Iraq.
Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq.
Urol Int. 2025;109(3):270-277. doi: 10.1159/000541816. Epub 2024 Dec 4.
A comprehensive understanding of the renal vascular anatomy variations is paramount to a successful kidney transplant. This reduces vascular injury risks and minimizes ischemia duration, optimizing surgical outcomes. The current study aims to assess the accuracy of renal computed tomography angiography (CTA) findings of live renal donors by comparing them with intraoperative findings.
This prospective cross-sectional study was conducted between October 2018 and February 2020. It included all healthy donors with two kidneys of normal size, shape, and position who were deemed suitable for nephrectomy. The CTA examinations were performed with the same protocol, which combined the vascular-excretory phase. Anatomical findings were recorded by a specialized radiologist. The CTA results were compared with intraoperative findings, which were documented by the transplantation team.
The study included 220 patients. The preoperative CTA was highly sensitive and accurate, reaching 99.5% and 98.6%, respectively, for single vessels and 100% sensitivity and accuracy for triple vessels, pelvicalyceal system, and ureter duplication. The sensitivity of CTA for double vessels (vein and artery) was 90% and 92.6%, respectively, while accuracy was 98.6% for both.
CTA can be used to assess renal arteries and veins for potential renal donors with high accuracy. Although the CTA's minor, statistically nonsignificant discordance with the surgical findings regarding double arteries and veins, no artery or vein was missed on the CTA. Therefore, the sensitivity of CTA can reach 100%.
全面了解肾血管解剖变异对于成功进行肾移植至关重要。这可降低血管损伤风险并将缺血时间减至最短，从而优化手术效果。本研究旨在通过将活体肾供体的肾脏计算机断层血管造影（CTA）结果与术中发现进行比较，评估其准确性。
本前瞻性横断面研究于2018年10月至2020年2月进行。纳入所有健康供体，其双肾大小、形状和位置正常，被认为适合进行肾切除术。CTA检查采用相同方案，结合血管排泄期。由专业放射科医生记录解剖学发现。将CTA结果与移植团队记录的术中发现进行比较。
该研究纳入220例患者。术前CTA具有高度敏感性和准确性，单支血管的敏感性和准确性分别达到99.5%和98.6%，三支血管、肾盂肾盏系统及输尿管重复的敏感性和准确性均为100%。CTA对双支血管（静脉和动脉）的敏感性分别为90%和92.6%，两者的准确性均为98.6%。
CTA可用于高精度评估潜在肾供体的肾动脉和肾静脉。尽管CTA在双动脉和双静脉方面与手术发现存在轻微的、统计学上无显著差异的不一致，但CTA未遗漏任何动脉或静脉。因此，CTA的敏感性可达到100%。
