Selective intra-arterial 3-dimensional computed tomography angiography for preoperative evaluation of nephron-sparing surgery

Objective: To evaluate selective intra-arterial 3-dimensional computed tomography (3D-CT) angiography as a tool for the preoperative evaluation of nephron-sparing surgery (NSS). Methods: Twenty-three patients with renal cell carcinoma indicating NSS underwent selective intrarenal 3D-CT angiography. The time-lapse dual-phase technique was used for simultaneous vascular and urographic visualization. The 3D images were created by the shaded volume-rendering method. The CT attenuation of target structures was measured for quantitative evaluation. The 3D images were visually evaluated for the renal artery, vein, and collecting system using a grading system. Results were statistically analyzed. Results: The 3D-CT angiography depicted the intrarenal branches of the renal artery and vein and the whole collecting system in most patients. Visualization of the renal artery was significantly correlated to its CT attenuation. Visualization of the renal vein was correlated to its CT attenuation adjusted by the surrounding renal parenchyma. Conclusion: Selective intra-arterial 3D-CT angiography allows the detailed visualization of intrarenal structures.