Utility of CT angiography for evaluation of living kidney donors

We reviewed our initial experience with helical computed tomography (CT) angiography in the evaluation of living kidney donors which, until now, has necessitated arteriography. Nineteen donors (12 women, 7 men) have had their renal anatomy evaluated solely by CT angiography preoperatively. All scans demonstrated normal collecting systems and single ureters. Five donors (26%) had supernumerary renal arteries. Fourteen donors had single, 4 donors had two, and 1 donor had three renal arteries. Helical CT demonstrated small polar vessels in several donors. Two donors (10%) had supernumerary renal veins. Accuracy of vascular anatomy defined on CT was 90% when confirmed at operation. Anatomically all CT findings were consistent with operative findings except in 1 donor who was found to have a 0.8 cm lesion near the renal hilum. At our institution, the total charges for selective renal arteriography are $3845 and for helical CT with three-dimensional (3-D) reconstruction are $1546. The amount of contrast dye (approximately 100 mL) is equivalent. Patients uniformly reported that the CT scan was a convenient and painless procedure. The accuracy of helical CT angiography is equivalent to arteriography in assessing renal vascular anatomy (with the additional benefit of imaging venous and parenchymal anatomy). Charges for helical CT are 59% less. There is greater patient acceptance and potentially less morbidity associated with the non-invasive nature of helical CT. We believe that CT angiography is the radiologic procedure of choice for the assessment of renal anatomy in potential living kidney donors.

Hepatoblastoma: case report and literature review

Hepatoblastoma is the most common primary malignant hepatic neoplasm in children and must be differentiated from other hepatic tumors such as hepatocellular carcinoma, metastatic neuroblastoma, hemangioendothelioma, and mesenchymal hamartoma. A case report of hepatoblastoma with its attendant radiologic findings is presented. Because the prognosis is dependent on whether the tumor is surgically resectable, the accurate radiologic evaluation of patients with hepatoblastoma is critical. The roles of plain film radiography, ultrasound, computed tomography, and angiography in the evaluation of pediatric hepatic neoplasms are discussed.

Bronchopulmonary sequestration

Bronchopulmonary sequestration is a rare lesion making up less than 10% of all congenital pulmonary malformations. The two classic types, extralobar and intralobar, can be distinguished by whether or not the sequestered pulmonary tissue is enclosed by a separate visceral pleural lining. A case of intralobar bronchopulmonary sequestration is presented. At present, aortography is necessary to establish the diagnosis, but other imaging modalities including computed tomography, ultrasound, and magnetic resonance imaging offer the potential for additional useful information.