Preoperative Evaluation of Potential Living Related Kidney Donors with High-Spatial-Resolution Magnetic Resonance (MR) Angiography at 3 Tesla

Abstract

The purpose of this prospective study was to determine the feasibility and accuracy of high-spatial-resolution MR imaging at 3 Tesla (T) in the preoperative evaluation of potential living related kidney donors. Eighteen potential donors (8 men, 10 women; mean age, 50.1 ± 14.2 years) for renal transplantation were evaluated with 3 T MR imaging. A high-spatial-resolution 3-dimensional (3D) gradient-echo MR angiography (repetition time/echo time, 3.0/1.14 ms; flip, 19–23°; matrix, 512; slice thickness, 1.0 mm) using parallel acquisition technique (GRAPPA) with an acceleration factor of 3 was performed on a whole body scanner. Images were evaluated in a prospective and blinded fashion by 2 MR radiologists. The number of renal arteries, presence of early branches (defined as a branch arising within 2 cm of the main renal ostium), and renal artery stenosis were analyzed. The renal parenchyma, collecting system and ureters, were evaluated on the MR urograms. Interpretation of MR images were compared with surgical findings. Based on MR angiography data sets, a total of 36 main and 9 accessory renal arteries was found. There were 5 renal arteries presenting an early branching (≤2 cm). The correct venous anatomy was identified in 13 of 14 patients (93%), including a single left renal vein anterior to the aorta (n = 3), retroaortic left renal vein (n = 2), and single right renal vein (n = 9). A single collecting system in all harvested kidneys was identified correctly with MR imaging. Overall, the sensitivity and positive predictive value of MRI in correctly determining the vascular and parenchymal anatomy in the harvested kidney was 85% and 93%, respectively. High-spatial-resolution contrast-enhanced MR angiography at 3 T can predict successful donor nephrectomy in potential living related kidney donors.