Title: The primary investigation of renal artery CTA for preoperative evaluation in patients with renal neoplasms
Abstract: Objective To estimate the ability of CT Angiography (CTA) to display normal anatomy and variants of renal arteries and its assistant value in tumors resection in patients with renal neoplasms. Methods Seventy consecutive patients with renal neoplasms underwent CTA before laparoscopic operation. In all the cases, renal CTA images were reconstructed using maximum intensity(MIP), multiplanar reformation(MPR) and volume rendering(VR) to observe the anatomy and variants. Number of renal arteries, presence of accessory renal arteries and early branching and other variants of renal arteries were noted. The presence of tumor-feeding arteries was also noted. According to the medical records, the surgical options and procedures were recorded and the consistency between intraoperative findings and the results of the CTA of the renal arteries were compared. The presence of vascular complications were also recorded. Results Seventy-three tumor leisions were identified in seventy patients by CT. The incidence of multiple renal arteries was 7.9% ( 11/140 ), and 19.3% ( 27/140) of the accessory renal arteries, 2.1% ( 3/140 ) of the early branching. Other variants included right phrenic arteries arising off the right renal arteries with the incidence of 12.9% ( 9/70 ) and adrenal branches from right renal arteries with the incidence of 1.4% (1/70 ). Tumor-feeding arteries could be identified in thirty-six out of seventy-three leisions. Sixty-six patients underwent retroperitoneal laparoscopic surgeries with thirty-nine of them undergoing partial nephrectomy and twenty-seven of them undegoing radical nephrectomy. Four patients underwent transperitoneal open surgeries. According to the medical records, the degree of consistency between intraoperative findings and the results of the CTA of the renal arteries were 100 % . No vascular injury or related complication occurred perioperatively in patients and none of the patients need to convert surgical procedure intraoperatively in this study. Conclusions The anatomy and variants of renal arteries in patients with renal neoplasms can be displayed clearly by multidetector CTA and tumor-feeding arteries can also be identified, and it's importancy in making surgical operation scheme and operating successfully for patients with renal neoplasms is significant. Especially in a laparoscopic surgery, it can reduce the complications of vascular injury effectively.
Publication Year: 2012
Publication Date: 2012-01-01
Language: en
Type: article
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