Non-invasive imaging of living kidney donors: intraindividual comparison of multislice computed tomography angiography with magnetic resonance angiography

Background Evaluation of vascular variants is crucial for donor assessment prior to living kidney transplantation. Both contrast-enhanced (CE) magnetic resonance angiography (MRA) and multislice computed tomography (MSCT) are currently used for imaging living kidney donors. Aim of this study was the comparison of the accuracy of MSCT angiography and CE-MRA for the assessment of renal vascular anatomy. Methods Prospective study at a university transplant center including 65 potential living kidney donors. Pre-operative imaging by MSCT angiography and CE-MRA was correlated with the findings of laparoscopic donor nephrectomy in 48 donors. Results MSCT detected significantly more patients and more kidneys with accessory arteries than CE-MRA (p < 0.05). MSCT and CE-MRA performed similarly in identifying venous and ureteral abnormalities. The overall sensitivity, specificity, and accuracy for identifying accessory arteries were 85%/97%/94% for MSCT and 54%/97%/85% for CE-MRA. The sensitivity, specificity, and accuracy for the identification of supernumerary veins were 67%/95%/92% for MSCT and 67%/98%/94% for CE-MRA, respectively. Conclusion We found MSCT angiography to be more sensitive and accurate than CE-MRA in the detection of supernumerary arteries prior to living donor nephrectomy.