Helical CT angiography for examination of living renal donors.

OBJECTIVE: This prospective study was intended to determine if helical CT arteriography plus conventional radiography is sufficiently accurate to replace and less costly than excretory urography and conventional renal arteriography, the techniques currently used to examine living renal donors. SUBJECTS AND METHODS: Patients underwent CT arteriography with a helical CT scanner. Conventional radiographs were obtained during the pyelographic phase to evaluate the urothelium. Findings on CT arteriograms were compared with findings on conventional arteriograms and at surgery. RESULTS: Of 57 patients who underwent CT arteriography, 46 also underwent conventional arteriography and 40 underwent surgery. For those 46 patients, we found agreement between results of CT arteriography and conventional arteriography in 89% of kidneys. For those 40 patients, we found agreement between results of CT arteriography and findings at surgery in 90% of kidneys and agreement between results of conventional arteriography and findings at surgery in 87% of kidneys. Of the 57 patients, six (11%) had findings on CT angiograms that precluded further consideration for donation. CONCLUSION: Eight to ten percent of renal arteries are not seen on renal arteriograms when compared with findings at surgery. Our results indicate that CT arteriography is as accurate as conventional arteriography at revealing the number of vessels that perfuse and drain the kidneys and can replace conventional arteriography. Use of CT angiography plus conventional radiography instead of excretory urography and conventional arteriography can result in a 35-50% reduction in cost of the imaging studies in potential renal donors.

Female urethral diverticula: double-balloon catheter study.

A double-balloon catheter was used to evaluate the female urethra in 51 patients. Six different radiographic appearances were identified. Three of the categories are considered variants of normal. One of the categories consisted of eight patients with urethral diverticula. All showed large rounded or lobulated collections of contrast material which were adjacent to the urethra and which persisted on postvoid films. Other abnormalities should be closely correlated with the clinical findings to determine their significance. The diagnosis of urethral diverticulum may be missed, as physical examination and endoscopy can be negative. Therefore, the optimal method for identifying its presence and extent includes both a double-balloon catheter study and a voiding cystourethrogram.