Role of. CT. Angiography in the Preoperative Evaluation for Lap aro- ,,i scopic Nephrectomy1 Patricia A. Smith, MD Lloyd E. Ratner, MD . Frank C. Lynch, MD Frank M Con, MS Elliot K Fishman, MD Laparoscopic nephrectomy (LN) was recently introduced as a minimally invasive alternative to open nephrectomy in living related renal donation. Because of the limited field of view available with laparoscopic tech- niques, the role of preoperative radiologic evaluation in LN has expanded to include anatomic defmition of the renal arteries, collecting system, re- nal parenchyma, and renal venous anatomy. Computed tomographic (CT) angiography has proved to be a minimally invasive alternative to conven- tional angiography in the preoperative evaluation of living related renal donors. CT angiography has been shown to have an accuracy comparable to that of conventional angiography in predicting renal arterial anatomy. In addition, CT angiography provides comprehensive defmition of the re- nal vascular anatomy including the location, size, and length of the renal, adrenal, gonadal, and lumbar veins. Dual-phase spirai CT combined with three-dimensional CT angiography constitute a single, minimally invasive procedure that can provide a complete preoperative evaluation of poten- tial living related renal donors prior to LN. Comprehensive anatomic de- piction of the renal arterial and venous supplies aids in surgical planning and helps avoid potential complications. Abbreviations: PVC inferior vena cava, LN = laparoscopic nephrectomy, 3D = three-dimensional Index terms: Computed tomography (CT). angiography, 81.12116 ‘ Computed tomography (CT), helical. 81.12115 Computed tomography (CT), three-dimensional, 81 . 121 17 #{149} Computed tomography (CT), volume rendering, 81.12117 Kidney, transplantation, 81.45 #{149} Laparoscopic surge ’, 81.45 RadloGraphics 1998; 18:589-61)1 ‘From the Departments of Radiology (P.A.S., F.C.L., F.M.C. . E.K.F.) and Surgery (L.E.R.), Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, 601 N Caroline St, Baltimore, MD 21287. Pre. sented as a scientific exhibit at the 1997 RSNA scientific assembly. Received December 19, 1997; revision requested janu. ary 8, 1998 and receivedjanuary 14; acceptedJanuary 14. Address reprint requests to E.K.F. ©RSNA, 1998 See also the article by Pozniak et al (pp 565-587) and the commentary by Rubin (pp 61)1-604) in this issue. 589