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Helical CT in Renal Transplantation: Normal Findings and Early and Late Complications¹

¹ From the Institute for Diagnostic Imaging (C.S., S.Q.) and the Departments of Radiology (R.B., M.F.P., A.A.) and Nephrology (C.C.), Hospital General Universitari Vall d’Hebron, Passeig Vall d’Hebron 119-129, Barcelona 08035, Spain. Presented as an education exhibit at the 2000 RSNA scientific assembly. Received March 15, 2001; revision requested April 17 and received May 21; accepted May 25. Address correspondence to C.S. (e-mail: sebastia@hg.vhebron.es).

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.

Index Terms: Kidney, CT, 81.12115, 81.12116, 81.12117 • Kidney, diseases, 81.455 • Kidney, transplantation, 81.455 • Renal angiography, 81.12116

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