Clinical and Radiation Diagnosisof Renal Arteriovenous Malformation

Purpose: to analyze the results of preoperative diagnosis and treatment of patients with renal arteriovenous malformation and compare them with the literature data.

Materials and methods. 5 patients with renal arteriovenous malformations were examined for the period from 2014 to2016 in the FSBI "A.V. Vishnevsky Institute of Surgery» MH RF, where simultaneously there are clinical departments of urology and vascular surgery, 4 of them were treated. All patients were female. The mean age was 31.8 ± 6.7 years (24–41 years). Ultrasound was done to all the patients in B-mode followed by a duplex scan using an abdominal 2–4 MHz convex. MDCT was performed in 4 patients out of 5. Patients underwent multiphase examination on a multidetector CT-scanner Philips Brilliance iCT-256 and Brilliance CT-64 (Philips Medical Systems (Cleveland) with the 120 kV and 100 kV protocols and an intravenous injection of the iodinated contrast agent. Digital subtraction angiography was performed in 3 patients.

Results. One-sided lesion occurred in four cases (3 of them (60%) right-sided and 1 (20%) left-sided), in one patient (20%) arteriovenous malformation was bilateral As a result of the analysis of our own material and literature data, the diagnostic criteria of renal arteriovenous malformations according to ultrasound, MDCT and digital subtraction angiography were studied in detail. The results of the examinations of 5 patients with demonstration of ultrasound, MDCT and angiographic images are presented with the visualization of the characteristic features of renal AVM. In addition, the treatment options for such patients with the possibility of preserving the kidney are described.

Conclusion. Duplex scanning is an effective method of diagnosis and postoperative follow-up of patients with renal arteriovenous malformations. Preoperative computed tomography and selective digital subtraction angiography provide accurate information about the renal angioarchitectonics and AV-shunts for choosing the treatment tactics and planning the surgical intervention. 

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