Living donor kidneys: usefulness of 16-slice multi-detector row CT for preoperative evaluation

To assess in living renal donors the accuracy of 16-slice multi-detector row CT [MDCT] in the evaluation of renal vasculature and the upper urinary tract by using surgery as the reference standard. This study was approved by our institutional review board for human investigation. 63 consecutive potential kidney donors [38 men and 25 women; mean age, 40.7 years] underwent 16-channel MDCT. Unenhanced CT of the abdomen was performed. Next, 100mL of nonionic contrast material was injected at a rate of 4-5mL/sec. Arterial, nephrographic and excretory phase volumetric data sets were acquired at 20-25 seconds, 70-75 seconds, and 10min after start of injection respectively. Volumetric reconstructions were performed at a CT workstation for the 1mm sections of the arterial and nephrographic phases. These included coronal and oblique coronal overlapping thin MIP as well as 3D MIP reconstructions parallel to the renal hilar vessels. CT urographic images were reconstructed from the excretory phase CT data in the coronal or oblique coronal plane by using MIP. Each scan was evaluated independently for renal vascular and ureteral anatomic variants. Findings at CT were compared with those at surgery. Sensitivity, specificity and accuracy of MDCT were calculated on the basis of presence or absence of variant anatomy at surgery. CT depicted 76 of 77 renal arteries confirmed at surgery, one accessory artery was misinterpreted at CT as early branching artery. CT depicted 66 of 67 renal veins confirmed at surgery. Overall accuracy of CT was 98.4%, 98.4% and 100% for identification of variant anatomy of renal arteries, veins and ureters, respectively. 16-channel MDCT used as the sole minimally invasive imaging technique in the comprehensive evaluation of living renal donor candidates provides high accuracy for detecting renovascular and ureteric anomalies

Colonic wall thickening in cirrhotic patients CT findings and clinical significance

The purpose of this study was to determine the spectrum of colonic wall changes in patients with cirrhosis and to assess its clinical significance by CT. 80 patients clinically diagnosed as liver cirrhosis underwent triphasic CT study of the liver. They were evaluated for the degree and extent of colonic involvement. Other features of cirrhosis including portal hypertension, ascites and splenomegaly were also recorded. Colonic wall thickening >6mm was seen in the 41% [33/80] of the patients. The ascending colon and ceacum were involved in 17 cases. The ascending and transverse colon were involved in 11 cases while the ascending, transverse and descending colon were involved in 5 cases. Portosystemic collaterals were present in 33 cases of colonic wall thickening. Splenomegaly, was present in all the examined cases. Ascites was present in 20 cases, all of them has colonic wall thickening. Colonic wall thickening was limited predominantly to the right colon which could be explained due to portal hypertension and can be used as one of the indicators of poor prognosis in cirrhotic patients. CT can be used as one of the indicators of poor prognosis in patients of liver cirrhosis