Article

Three-dimensional helical CT angiography in renal transplant recipient: A new problem-solving tool

Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
American Journal of Roentgenology (Impact Factor: 2.73). 11/1999; 173(4):1085-9. DOI: 10.2214/ajr.173.4.10511184
Source: PubMed

ABSTRACT

OBJECTIVE: Our objective was to describe the use of three-dimensional helical CT angiography for the evaluation of renal transplant recipients presenting with hypertension, graft dysfunction, or both after transplantation by evaluating the native and transplanted renal arteries in a single examination. CONCLUSION: Early results indicate that three-dimensional helical CT angiography of renal transplant recipients presenting with hypertension, graft dysfunction, or both after transplantation yields valuable information that can be used to guide further therapy.

Full-text preview

Available from: ajronline.org
  • [Show abstract] [Hide abstract]
    ABSTRACT: Three-dimensional volume-rendered computed tomographic (CT) angiography represents an increasingly important clinical tool that, in many institutions, is replacing conventional angiography in the depiction of normal vascular anatomy and the diagnosis of vascular disorders. Evaluation of conditions affecting the renal vasculature constitutes a major focus of volume-rendered CT angiography, which has documented utility for demonstrating both arterial and venous disease. Arterial disorders include renal artery stenosis, renal artery aneurysms, and dissection. Venous disorders include splenorenal shunts, thrombosis, and intravascular tumor extension. In addition, volume-rendered CT angiography accurately displays the normal and variant renal vascular anatomy, which is crucial to detect before surgery, especially partial nephrectomy and laparoscopic nephrectomy. CT angiography is also useful in the evaluation of the renal vasculature following renal transplantation. Familiarity with proper CT protocols and data acquisition techniques are crucial for accurate diagnosis.
    No preview · Article · Mar 2001 · Radiographics
  • [Show abstract] [Hide abstract]
    ABSTRACT: Over a 5-year period, 346 helical computed tomographic (CT) studies were performed in renal transplant recipients. Helical CT proved useful in this context by depicting parenchymal, perirenal, renal sinus, pyeloureteral, and vascular complications in great detail. CT often delineates fluid collections and their anatomic relationship to adjacent structures better than ultrasonography (US), particularly in obese patients. CT-guided puncture and drainage can be performed in cases in which US is deemed inadequate. CT angiography can depict arterial diseases such as stenosis, thrombosis, arteriovenous fistulas, aneurysms, and pseudoaneurysms in the graft artery and in the recipient iliac arterial system, thereby obviating conventional angiography in some cases. Helical CT with three-dimensional image reformatting allows accurate imaging of the entire course of ureteral and periureteral diseases (eg, hydronephrosis, ureteral leak and stricture, pyeloureteral obstruction). CT can be used in the confirmation and staging of malignancies of the renal parenchyma and urothelium. It is also helpful in evaluating associated disease in the native kidneys, acute and chronic rejection, graft embolization, and end-stage disease. Although US and nuclear medicine examination are the imaging modalities of choice in renal transplantation, helical CT is a valuable alternative when these techniques are inconclusive.
    No preview · Article · Sep 2001 · Radiographics
  • [Show abstract] [Hide abstract]
    ABSTRACT: The applications of three-dimensional (3D) CT techniques encompass a spectrum from calculus disease to preoperative planning. With proper selection of display windows and levels, accurate measurement of stone size can be achieved, along with volumetric information. A CT scan with reconstruction may help guide the direction of an endopyelotomy incision away from crossing vessels. The benefits of 3D CT in the evaluation of living renal donors include lower cost and decreased patient morbidity. In renal allograft recipients and other patients, the study may be used to investigate hypertension. Also, 3D CT is invaluable in planning nephron-sparing surgery for renal masses. The ultimate role of this modality rests in the hands of clinicians who can benefit from them and the radiologists who must provide the high-quality images and the interpretive expertise.
    No preview · Article · Mar 2001 · Journal of Endourology
Show more