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J Clin Imaging Sci. 2016 Jan 28;6:1. doi: 10.4103/2156-7514.175079. eCollection 2016.

Renal Collecting System Anatomy in Living Kidney Donors by Computed Tomographic Urography: Protocol Accuracy Compared to Intravenous Pyelographic and Surgical Findings.

Author information

1
Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran.
2
Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA.
3
Department of Urology and Transplantation, Tabriz University of Medical Sciences, Tabriz, Iran.
4
Student's Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
5
Medical Philosophy and History Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran; Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
6
Department of Medicine, Division of Cardiology, University of Florida College of Medicine, Gainesville, Florida, USA.
7
Department of Diagnostic Radiology and Nuclear Medicine, University of California Davis Medical Center, Sacramento, CA, USA.

Abstract

OBJECTIVES:

To evaluate the accuracy of triple-bolus computed tomography urography (CTU) as a surrogate of intravenous pyelography (IVP) for determining the anatomy of the urinary collecting system in living kidney donors.

MATERIALS AND METHODS:

In an analytic descriptive cross-sectional study, 36 healthy kidney donors were recruited during 12 months. Preoperative IVP and CTU were utilized to evaluate kidneys' anatomy; major and minor calyces and variation were used as anatomical indices to compare the accuracy of CTU and IVP; the images were then compared to surgical findings.

RESULTS:

Thirty-six kidney donors (92% male; mean age: 28 ± 6 years) were enrolled in this study. The kappa coefficient value was significant and almost perfect for the CTU and IVP findings in detecting the pattern of calyces (kappa coefficient 0.92, asymptotic 95% confidence interval 0.86-0.97). Anatomic variations or anomalies of the urinary collecting system included the bifid pelvis (5.6%), duplication (8.3%), and extra-renal pelvis (2.8%). Both the sensitivity and specificity of CTU in the detection of the anatomy and variations were 100%; the sensitivity and specificity of IVP were 83.3% and 100%, respectively.

CONCLUSIONS:

The triple-bolus preoperative CTU can be considered an alternative to IVP for assessing the anatomy of the urinary collecting system.

KEYWORDS:

Anatomy; computed tomography urography; donor; intravenous pyelography; kidney transplant

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