Renal ven anomalilerinin insidansının ve renal taş hastalığı ve renal tümörlerle ilişkisinin abdominal multidedektör bilgisayarlı tomografi ile değerlendirilmesi

Amaç: Bu çalışmada renal ven anomali (RVA) tiplerinin insidansı ile böbrek taş hastalığı ve böbrek tümörleri ile ilişkisinin çok kesitli bilgisayarlı tomografi (ÇKBT) ile değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: 10124 hastanın abdominal ÇKBT görüntüleri retrospektif olarak değerlendirdi. Dışlama kriterleri sonrasında son çalışma popülasyonu 9294 hastadan oluşuyordu. Hastaların demografik özellikleri, RVA varlığı, böbrek taşı hastalığı ve böbrek tümörü varlığı kaydedildi. RVA'lar üç alt gruba ayrıldı: retroaortik sol renal ven (RSRV), sirkumaortik sol renal ven (SSRV) ve çift sağ renal ven (ÇSRV). RVA'lı hastalarda böbrek taşı hastalığı ve böbrek tümörlerinin varlığı kaydedildi. Bulgular: 1389 olguda RVA (%14.9) vardı. Erkeklerde RVA kadınlara göre daha yüksekti. RSRV, SSRV ve ÇSRV prevalansı sırasıyla %9.5, %3.9 ve %1.9 idi. 1389 RVA vakasının 20'sinde böbrek tümörü ve 243'ünde böbrek taşı hastalığı tespit edildi, istatistiksel olarak anlamlı bir korelasyon yoktu. Ancak sol böbrek taşı hastalığı ile RSRV ve SSRV arasında istatistiksel olarak anlamlı bir ilişki bulundu. Sonuç: Popüler inanışın aksine, RVA'lar nadir değildir. Olası komplikasyonları önlemek için retroperitoneal cerrahi öncesi RVA varlığının bilinmesi çok önemlidir. Ayrıca RSRV ve SSRV 'nin sol böbrek taşı hastalığının gelişimine zemin hazırlayan faktörler olduğu düşünülmektedir.

Anahtar Kelimeler:

Renal ven, anomali, X-ray bilgisayarlı tomografi, böbrek taşı hastalığı, böbrek tümörü

Evaluation of the incidence of renal vein anomalies and their relationship with renal stone disease and renal tumors by abdominal multidetector computed tomography

Purpose: This study aimed to evaluate the types and incidence of renal vein anomaly (RVA) and their relationship with renal stone disease and renal tumors with multidetector computed tomography (MDCT). Materials and Methods: We evaluated retrospectively 10124 patients abdominal MDCT images. After the exclusion criteria, the final study population consisted of 9294 patients. The demographic characteristics of the patients, the presence of RVA, the presence of renal stone disease and renal tumor were recorded. RVAs were separated into three subgroups: retroaortic left renal vein (RLRV), circumaortic left renal vein (CLRV), and double right renal vein (DRRV). The presence of renal stone disease and renal tumors were recorded in patients with RVAs. Results: 1389 cases had RVA (14.9%). RVA was higher in males than females. The prevalence of DRRV, RLRV, and CLRV were 9.5%, 3.9%, and 1.9%, respectively. Renal tumors was detected in 20, and renal stone disease was detected in 243 of 1389 RVA cases, there was no statistically significant correlation. However, a statistically significant correlation was found between left renal stone disease with RLRV and CRLV. Conclusion: Contrary to popular belief, RVAs are not uncommon. It is very important to know the presence of RVA before retroperitoneal surgery to prevent possible complications. In addition, RLRV and CLRV are thought to be factors that predispose to the development of left renal stone disease.

Keywords:

Renal vein, anomaly, X-ray computed tomography, renal stone disease, renal tumor,

PDF

___

1. Mathews R, Smith PA, Fishman EK, Marshall FF. Anomalies of the inferior vena cava and renal veins: Embryologic and surgical considerations. Urology. 1999;53:873-80.
2. Ozgul E. Evaluating incidence and clinical importance of renal vein anomalies with routine abdominal multidetector computed tomography. Abdom Radiol (NY). 2021;46:1034-40.
3. Dilli A, Ayaz UY, Kaplanoglu H, Saltas H, Hekimoglu B. Evaluation of the renal vein variations and inferior vena cava variations by means of helical computed tomography. Clin Imaging. 2013;37:530-5.
4. Hostiuc S, Rusu MC, Negoi I, Dorobantu B, Grigoriu M. Anatomical variants of renal veins: A meta-analysis of prevalence. Sci Rep. 2019;9:10802.
5. Tatar I, Töre HG, Celik HH, Karcaaltincaba M. Retroaortic and circumaortic left renal veins with their CT findings and review of the literature. Anatomy. 2008;2:72-6.
6. Deák PÁ, Doros A, Lovró Z, Toronyi E, Kovács JB, Végso G et al. The significance of the circumaortic left renal vein and other venous variations in laparoscopic living donor nephrectomies. Transplant Proc. 2011;43:1230-2.
7. Atalar MH, Kosar MI, Salk I, Isleyen M. Left renal vein abnormalities detected during routine abdominal computed tomography imaging: Clinico-radiological significance. Folia Morphol (Warsz). 2012;71:168-72.
8. Arslan H, Etlik O, Ceylan K, Temizoz O, Harman M, Kavan M. Incidence of retro-aortic left renal vein and its relationship with varicocele. Eur Radiol. 2005;15:1717–20.
9. Janschek EC, Rothe AU, Holzenbein TJ, Langer F, Brugger PC, Pokorny H et al. Anatomic basis of right renal vein extension for cadaveric kidney transplantation. Urology. 2004;63:660–4.
10. Mandal AK, Cohen C, Montgomery RA, Kavoussi LR, Ratner LE. Should the indications for laparascopic live donor nephrectomy of the right kidney be the same as for the open procedure? Anomalous left renal vasculature is not a contraindiction to laparoscopic left donor nephrectomy. Transplantation 2001;71,660–4.
11. Hoeltl W, Hruby W, Aharinejad S. Renal vein anatomy and its implications for retroperitoneal surgery. J Urol. 1990;143:1108-14.
12. Heidler S, Hruby S, Schwarz S, Sellner-Zwieauer Y, Hoeltl W, Albrecht W. Prevalence and incidence of clinical symptoms of the retroaortic left renal vein. Urol Int. 2015;94:173-6.
13. Satyapal KS, Kalideen JM, Haffejee AA, Singh B, Robbs JV. Left renal vein variations. Surg Radiol Anat. 1999;21:77-81.
14. Dilli A, Ayaz UY, Karabacak OR, Tatar IG, Hekimoglu B. Study of the renal variations by means of magnetic resonance imaging. Surg Radiol Anat. 2012;34:267-70.
15. Karaman B, Koplay M, Ozturk E, Basekim CC, Ogul H. Retroaortic left renal vein: Multidetector computed tomography angiography findings and its clinical importance. Acta Radiol. 2007;48:355-60.
16. Macchi V, Parenti A, De Caro R. Draining of a retroaortic left renal vein via the ‘subcentral veins’ into the inferior vena cava. J Anat. 2001;99:621-3.
17. Shindo S, Kubato K, Kojima A, Iyori K, Ishimoto T. Anomalies of inferior vena cava and left renal vein: risks in aortic surgery. Ann Vasc Surg. 2000;14:393-6.
18. Klemm P, Fröber R, Köhler C, Schneider A. Vascular anomalies in the paraaortic region diagnosed by laparoscopy in patients with gynaecologic malignancies. Gynecol Oncol. 2005;96:278-82.
19. Boyaci N, Karakas E, Dokumacı DS, Yildiz S, Cece H. Evaluation of left renal vein and inferior vena cava variations through routine abdominal multi-slice computed tomography. Folia Morphol (Warsz). 2014;73:159-63.