Left adrenal vein localization by 3D real-time volume-rendering CTA before laparoscopic nephrectomy in living renal donors

Background: We investigated whether the left adrenal vein could be consistently localized on three-dimensional (3D) real-time volume-rendering computed tomographic angiographic (CTA) mapping in a group of living renal donors before laparoscopic nephrectomy. Methods: Sixty-six consecutive potential renal donors were referred for CTA vascular mapping before laparoscopic donor nephrectomy. Thirty-three patients were examined on a single-detector helical CT scanner and the other 33 were examined on a multidetector unit. In each patient, arterial phase and venous phase volumetric data sets were acquired after the intravenous injection of 150 cc of non-ionic contrast material. Three radiologists reviewed the data sets at a free-standing workstation after the application of 3D volume-rendering software and reached a concensus on whether the left adrenal vein was visualized and, when seen, its position relative to the abdominal aorta. Results: The left adrenal vein was found in 92.5% of the 66 donors (91% in the single-detector group and 94% in the multidetector group). The junction of the left adrenal vein and left renal vein averaged 5.2 mm (range = 0-13 mm) from the left lateral wall of the abdominal aorta. Conclusion: Three-dimensional real-time volume-rendering CTA with single-detector and multidetector scanners permits consistent localization of the left adrenal vein in more than 90 % of prospective living renal donors.