Perihilar branching patterns of renal artery and extrarenal length of arterial branches and tumour-feeding arteries on multidetector CT angiography

Br J Radiol. 2013 Mar;86(1023):20120387. doi: 10.1259/bjr.20120387.


Objective: The purpose of our study was to assess the extrarenal length of renal arterial branches and tumour-feeding arteries on multidetector CT (MDCT) angiography, in addition to the perihilar branching patterns, with relevance to segmental artery clamping.

Methods: MDCT angiograms of 64 patients with renal masses <4 cm were retrospectively reviewed by 2 radiologists. The perihilar branching patterns of the single main renal artery were assessed according to the number of pre-segmental and segmental arteries. The extrarenal lengths of segmental plus pre-segmental arteries and the tumour-feeding arteries, measured on volume-rendered images, were compared according to the vascular segmentation and the tumour location, respectively.

Results: In the 116 kidneys, 1 pre-segmental plus 5 segmental arteries (n=48) was the most common branching pattern. The mean extrarenal length of the inferior segmental plus pre-segmental arteries (33.05 mm) and the posterior segmental plus pre-segmental arteries (32.30 mm) was longer than any of the other segmental plus pre-segmental arteries (apical, 23.87 mm; superior, 26.80 mm; middle, 29.23 mm) (p<0.05). The mean extrarenal length of the lower pole tumour-feeding arteries (35.94 mm) was longer than those of the upper and mid-pole tumour-feeding arteries (24.95 mm, 29.62 mm), with significant difference between the lower and the upper pole tumour-feeding arteries (p<0.05).

Conclusion: Tumours in the lower pole, supplied by the inferior or posterior segmental artery, may be more amenable to segmental artery clamping.

Advances in knowledge: MDCT angiography with volume rendering can demonstrate the extrarenal length of tumour-feeding arteries and may help in determining the accessibility for segmental artery clamping.

MeSH terms

  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Kidney Neoplasms / blood supply*
  • Kidney Neoplasms / diagnostic imaging*
  • Kidney Neoplasms / pathology
  • Male
  • Middle Aged
  • Multidetector Computed Tomography
  • Organ Sparing Treatments
  • Renal Artery / anatomy & histology*
  • Renal Artery / diagnostic imaging
  • Retrospective Studies