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MR Imaging: A "One-Stop Shop" Modality for Preoperative Evaluation of Potential Living Kidney Donors¹

¹ From the Departments of Radiology (S.M.H., M.C.J.M.K., P.M.T.P., M.G.M.H., G.P.K.), Epidemiology and Biostatistics (M.C.J.M.K., M.G.M.H.), and Surgery (J.N.M.I.), Erasmus Medical Center, Dr Molewaterplein 40, 3015 GD Rotterdam, the Netherlands. Recipient of an Excellence in Design award for an education exhibit at the 2001 RSNA scientific assembly. Received March 21, 2002; revision requested May 2 and received June 24; accepted June 25. Address correspondence to S.M.H.

At many institutions, magnetic resonance (MR) angiography is the technique of choice for assessment of the renal arteries and renal parenchyma in potential living kidney donors. The renal arteries and renal veins have a varied anatomy and may consist of one or more vessels at several levels with variable calibers and levels of branching. These findings may play an important role in the surgeon’s decision about which kidney to harvest, especially if laparoscopic nephrectomy is used. A comprehensive MR imaging protocol is used at one hospital to assess the arteries, veins, parenchyma, and collecting system of the kidneys. The protocol includes T2-weighted single-shot fast spin-echo imaging, fat-saturated T2-weighted fast spin-echo imaging, three-dimensional MR angiography and MR venography, and delayed fat-saturated three-dimensional T1-weighted gradient-echo imaging. Meticulous assessment of the source images as well as images produced with various postprocessing methods, such as full maximum intensity projection, targeted maximum intensity projection, and axial and oblique reformation, allows detailed description of the vascular anatomy and its relationship to the collecting system and parenchyma to facilitate the surgeon’s decision making. The findings of MR imaging are comparable with those of other imaging modalities.

© RSNA, 2003

Index Terms: Kidney, MR, 81.1214 • Kidney, transplantation, 81.455 • Renal arteries, MR, 961.12942 • Renal veins, MR, 966.12942

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