Multi-detector computed tomography angiography (MDCTA) is considered a non-invasive, fast, and safe technique. MDCT plays an important role for surgeons before renal operations, for renal vascular anatomy evaluation. It also helps in the detection of renal vascular variants as the number, size, and course as well as the relation between renal vessels, which help to avoid hemorrhagic complications during operation.
Normally, both renal arteries are arising at level L1-2 from the abdominal aorta, inferiorly from the origin of the superior mesenteric artery by about 1 cm, while normally the left renal vein runs anteriorly between the SMA and the aorta to drain into the medial aspect of the inferior vena cava while the right drains into the lateral aspect of the inferior vena cava.
For renal arterial variants; accessory renal arteries are the most common renal vascular variant which represented one-third of cases 30% of them are unilateral and 10 % are bilateral accessory renal arteries. Other renal arterial variant is extra-hilar or early branchingrenal artery.
For renal venous variants, it is important to demonstrate variations such as circum-aortic, retro-aortic, or multiple renal veins to avoid vein incisions that lead to bleeding during different surgical procedures such as donor nephrectomy.