Öz
Aim: Variations of renal artery (RA), a pair of branches of the abdominal aorta, are very common. In the literature, these variations are shown by cadaveric and imaging methods in different populations. This study aimed to evaluate the diameters, numbers, origins, and branchings of RA by the Multi-detector (MD) Computerized Tomography Angiography (CTA), and to compare the results of the determined variations with those in the literature. Material and Method: The study included 206 patients aged 18– 85 years with CTA images. An experienced radiologist analyzed all images in two and three-dimensional reconstructions. The diameters, numbers, branchings and origin levels of RA were evaluated. Results: In a total of 206 patients, 50% RA variation was detected including 71 multiple RA and 32 early branching. The prevalence of multiple RA and early branching in men was 39.7% and 34.9%, respectively. RA anomalies were observed 26% and 18.8%, respectively in women. The most observed variation was the presence of an accessory RA in the right or left kidney (23.5%). The mean RA diameters are 5.17 mm (1.8–7.9 mm) for the right RA and 5.13 mm (1.5–9.1 mm) for left RA. All RA origin levels are between the T12 vertebral corpus and the L4–5 intervertebral disc distance. L1 vertebral corpus (46%) was the most common level. Conclusion: As a result, 50% variation is observed in RA according to the typical pattern. Knowledge of these variations is essential in kidney transplantation. CTA is a beneficial and effective method for demonstrating these variations.
Anahtar Kelimeler
Kaynakça
- 1. Chakravarthi KK. Unilateral multiple variations of renal, phrenic, suprarenal, inferior mesenteric and gonadal arteries. J Nat Sci Biol Med 2014;5:173–5. 2. Satheesha Nayak B, Kumar N, Sirasanagandla SR and Deepthinath R. Arterial glomerulus at the hilum of the right kidney and the abnormal course of the right testicular artery: a case report. Acta Med Iran 2014;52:414–7. 3. Shetty P and Nayak SB. A Detailed Study of Multiple Vascular Variations in the Upper Part of Abdomen. J Cardiovasc Echogr 2017;27:7–9. 4. Dhar P and Lal K. Main and accessory renal arteries--a morphological study. Ital J Anat Embryol 2005;110:101–10. 5. Tadipi S, Sadashiv R, Muralidharan S and Pimid M. Urogenital Vascular Anomalies with Bilateral Kinking of Ureter: A Case Report. Malays J Med Sci 2015;22:67–70. 6. Nayak SB. Presence of accessory renal artery and kinking of aorta due to the abnormal origin of renal arteries. . The Internet Journal of Biological Anthropology 2008;1:1. 7. Kornafel O, Baran B, Pawlikowska I, Laszczynski P, Guzinski M and Sasiadek M. Analysis of anatomical variations of the main arteries branching from the abdominal aorta, with 64-detector computed tomography. Pol J Radiol 2010;75:38–45. 8. Satyapal KS, Haffejee AA, Singh B, Ramsaroop L, Robbs JV and Kalideen JM. Additional renal arteries: incidence and morphometry. Surg Radiol Anat 2001;23:33–8 9. Munnusamy K, Kasirajan SP, Gurusamy K, Gurusamy K, Raghunath G, Bolshetty SL, Chakrabarti S, et al. Variations in Branching Pattern of Renal Artery in Kidney Donors Using CT Angiography. J Clin Diagn Res 2016;10: AC01–3. 10. Gumus H, Bukte Y, Ozdemir E, Cetinçakmak MG, Tekbaş G, Ekici F, et al. Variations of renal artery in 820 patients using 64-detector CT-angiography. Ren Fail 2012;34:286–90. 11. Cinar C and Turkvatan A. Prevalence of renal vascular variations: Evaluation with MDCT angiography. Diagn Interv Imaging 2016;97:891–7. 12. Cicekcibasi AE, Ziylan T, Salbacak A, Seker M, Buyukmumcu M and Tuncer I. An investigation of the origin, location and variations of the renal arteries in human fetuses and their clinical relevance. Ann Anat 2005;187:421–7. 13. Sampaio FJ and Passos MA. Renal arteries: anatomic study for surgical and radiological practice. Surg Radiol Anat 1992;14:113–7. 14. Pozniak MA, Balison DJ, Lee FT, Jr., Tambeaux RH, Uehling DT and Moon TD. CT angiography of potential renal transplant donors. Radiographics 1998;18:565–87. 15. Gulas E, Wysiadecki G, Cecot T, Majos A, Stefańczyk L, Topol M, et al. Accessory (multiple) renal arteries - Differences in frequency according to population, visualizing techniques and stage of morphological development. Vascular 2016;24:531–7. 16. Johnson PB, Cawich SO, Shah SD, Aiken W, McGregor RG, Brown H, et al. Accessory renal arteries in a Caribbean population: a computed tomography based study. Springerplus 2013;2:443. 17. Zağyapan R, Pelin, C., & Kürkçüoğlu, A. . A retrospective study on multiple renal arteries in Turkish population. Anatomy 2009;3. 18. Hsu TH, Su L, Ratner LE, Trock BJ and Kavoussi LR. Impact of renal artery multiplicity on outcomes of renal donors and recipients in laparoscopic donor nephrectomy. Urology 2003;61:323–7. 19. Keibel F MF. Manual of Human Embryology. The development of the urogenital organs. Philadelphia: J. B. Lippincott Company, 1912. 20. Keibel F MF. Manual of human embryology: J. B. Lippincott, Philadelphia. 1912. 21. Ferrara N. Role of vascular endothelial growth factor in the regulation of angiogenesis. Kidney Int 1999;56:794–814. 22. Saldarriaga B, Pérez, A. F and Ballesteros, L. E. A direct anatomical study of additional renal arteries in a Colombian mestizo population. Folia morphologica 2008;67:129–34. 23. Tarzamni MK, Nezami N, Rashid RJ, Argani H, Hajealioghli P and Ghorashi S. Anatomical differences in the right and left renal arterial patterns. Folia Morphol (Warsz) 2008;67:104–10. 24. Leslie SW and Sharma S. Anatomy, Abdomen and Pelvis, Renal Artery. StatPearls. Treasure Island (FL)2018.
Öz
Amaç: Aorta abdominalis’in bir çift dalı olan arteria renalis (AR)’in varyasyonları oldukça sık görülmektedir. Literatürde farklı popülasyonlarda kadavra çalışmaları ve görüntüleme yöntemleri ile bu varyasyonlar gösterilmiştir. Bu çalışmanın amacı MD-BTA ile AR çaplarını, sayılarını, orjin seviyelerini ve dallanmalarını değerlendirmek ve saptanan varyasyonların literatürde yer alan sonuçlarla karşılaştırmasını yapmaktır.
Materyal ve Metot: Çalışmaya 18–85 yaş arası 206 olguya ait BTA görüntüsü dahil edilmiştir. Tüm görüntüler deneyimli bir radyolog tarafından iki ve üç boyutlu rekonstrüksiyonlarla analiz edilmiştir. AR çapları, sayıları, dallanmaları ve çıkış düzeyleri değerlendirilmiştir. Bulgular: Toplam 412 böbrekte, 71 çoklu AR ve 32 erken dallanma olmak üzere %50 AR varyasyonu saptandı. Çoklu AR ve erken dallanma prevelansı erkeklerde sırasıyla %39,7, %34,9 iken, kadınlarda sırasıyla %26, %18,8 olarak gözlendi. En çok gözlenen varyasyon sağ veya sol böbrekte aksesuar bir AR bulunması şeklindeydi (%23,5). AR çapları sağ böbrek arterleri için ortalama 5,17 mm (1,8–7,9 mm), sol AR için 5,13 mm (1,5–9,1 mm) bulundu. Tüm AR orjin düzeyleri T12 corpus vertebralis ile L4–5 discus intervertebralis mesafesi arasında olup; en sık L1 corpus vertebralis (%46) seviyesindeydi. Sonuç: Sonuç olarak AR’de normal paterne göre %50 oranında varyasyon görülmekte olup; bu varyasyonlarının bilinmesi böbrek transplantasyonu açısından önemlidir. BTA, bu varyasyonların gösterilmesinde oldukça faydalı ve etkin bir yöntemdir
Anahtar Kelimeler
Kaynakça
- 1. Chakravarthi KK. Unilateral multiple variations of renal, phrenic, suprarenal, inferior mesenteric and gonadal arteries. J Nat Sci Biol Med 2014;5:173–5. 2. Satheesha Nayak B, Kumar N, Sirasanagandla SR and Deepthinath R. Arterial glomerulus at the hilum of the right kidney and the abnormal course of the right testicular artery: a case report. Acta Med Iran 2014;52:414–7. 3. Shetty P and Nayak SB. A Detailed Study of Multiple Vascular Variations in the Upper Part of Abdomen. J Cardiovasc Echogr 2017;27:7–9. 4. Dhar P and Lal K. Main and accessory renal arteries--a morphological study. Ital J Anat Embryol 2005;110:101–10. 5. Tadipi S, Sadashiv R, Muralidharan S and Pimid M. Urogenital Vascular Anomalies with Bilateral Kinking of Ureter: A Case Report. Malays J Med Sci 2015;22:67–70. 6. Nayak SB. Presence of accessory renal artery and kinking of aorta due to the abnormal origin of renal arteries. . The Internet Journal of Biological Anthropology 2008;1:1. 7. Kornafel O, Baran B, Pawlikowska I, Laszczynski P, Guzinski M and Sasiadek M. Analysis of anatomical variations of the main arteries branching from the abdominal aorta, with 64-detector computed tomography. Pol J Radiol 2010;75:38–45. 8. Satyapal KS, Haffejee AA, Singh B, Ramsaroop L, Robbs JV and Kalideen JM. Additional renal arteries: incidence and morphometry. Surg Radiol Anat 2001;23:33–8 9. Munnusamy K, Kasirajan SP, Gurusamy K, Gurusamy K, Raghunath G, Bolshetty SL, Chakrabarti S, et al. Variations in Branching Pattern of Renal Artery in Kidney Donors Using CT Angiography. J Clin Diagn Res 2016;10: AC01–3. 10. Gumus H, Bukte Y, Ozdemir E, Cetinçakmak MG, Tekbaş G, Ekici F, et al. Variations of renal artery in 820 patients using 64-detector CT-angiography. Ren Fail 2012;34:286–90. 11. Cinar C and Turkvatan A. Prevalence of renal vascular variations: Evaluation with MDCT angiography. Diagn Interv Imaging 2016;97:891–7. 12. Cicekcibasi AE, Ziylan T, Salbacak A, Seker M, Buyukmumcu M and Tuncer I. An investigation of the origin, location and variations of the renal arteries in human fetuses and their clinical relevance. Ann Anat 2005;187:421–7. 13. Sampaio FJ and Passos MA. Renal arteries: anatomic study for surgical and radiological practice. Surg Radiol Anat 1992;14:113–7. 14. Pozniak MA, Balison DJ, Lee FT, Jr., Tambeaux RH, Uehling DT and Moon TD. CT angiography of potential renal transplant donors. Radiographics 1998;18:565–87. 15. Gulas E, Wysiadecki G, Cecot T, Majos A, Stefańczyk L, Topol M, et al. Accessory (multiple) renal arteries - Differences in frequency according to population, visualizing techniques and stage of morphological development. Vascular 2016;24:531–7. 16. Johnson PB, Cawich SO, Shah SD, Aiken W, McGregor RG, Brown H, et al. Accessory renal arteries in a Caribbean population: a computed tomography based study. Springerplus 2013;2:443. 17. Zağyapan R, Pelin, C., & Kürkçüoğlu, A. . A retrospective study on multiple renal arteries in Turkish population. Anatomy 2009;3. 18. Hsu TH, Su L, Ratner LE, Trock BJ and Kavoussi LR. Impact of renal artery multiplicity on outcomes of renal donors and recipients in laparoscopic donor nephrectomy. Urology 2003;61:323–7. 19. Keibel F MF. Manual of Human Embryology. The development of the urogenital organs. Philadelphia: J. B. Lippincott Company, 1912. 20. Keibel F MF. Manual of human embryology: J. B. Lippincott, Philadelphia. 1912. 21. Ferrara N. Role of vascular endothelial growth factor in the regulation of angiogenesis. Kidney Int 1999;56:794–814. 22. Saldarriaga B, Pérez, A. F and Ballesteros, L. E. A direct anatomical study of additional renal arteries in a Colombian mestizo population. Folia morphologica 2008;67:129–34. 23. Tarzamni MK, Nezami N, Rashid RJ, Argani H, Hajealioghli P and Ghorashi S. Anatomical differences in the right and left renal arterial patterns. Folia Morphol (Warsz) 2008;67:104–10. 24. Leslie SW and Sharma S. Anatomy, Abdomen and Pelvis, Renal Artery. StatPearls. Treasure Island (FL)2018.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Ocak 2019 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 9 Sayı: 1 |
