open access

Vol 77, No 1 (2018)
Original article
Submitted: 2017-07-09
Accepted: 2017-07-27
Published online: 2017-08-18
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The effect of anatomic differences on the relationship between renal artery and diaphragmatic crus

K. Esen1, S. Tok1, Yuksel Balci1, F. D. Apaydin1, E. Kara1, D. Uzmansel2
·
Pubmed: 28832087
·
Folia Morphol 2018;77(1):22-28.
Affiliations
  1. Mersin University, School of Medicine, Department of Radiology, Mersin Universitesi Tıp Fakultesi Hastanesi, Radyoloji Bolumu 34. Cadde Yenisehir, Mersin, Türkiye
  2. Department of Anatomy, Faculty of Medicine, Mersin University, Mersin, Turkey

open access

Vol 77, No 1 (2018)
ORIGINAL ARTICLES
Submitted: 2017-07-09
Accepted: 2017-07-27
Published online: 2017-08-18

Abstract

Background: The aim of this study is to investigate the effect of anatomic differences on the relationship between renal artery and diaphragmatic crus via the touch of two structures. Materials and methods: The study included dynamic computed tomography (CT) scans of 308 patients performed mainly for characterisation of liver and renal masses. Anatomic differences including the thickness of the diaphragmatic crus, the localisation of renal artery ostium at the wall of aorta, the level of renal artery origin with respect to superior mesenteric artery were evaluated. Statistical relationships between renal artery-diaphragmatic crus contact and the anatomic differences were assessed.

Results: Thickness of the diaphragmatic crus at the level of renal artery origin exhibited a statistically significant relationship to renal artery-diaphragmatic crus contact at the left (p < 0.001) and right side (p < 0.001). There was a statistically significant relationship between high renal artery origin and renal artery- -diaphragmatic crus contact at the left (p < 0.001) and right side (p = 0.01). The localisation of renal artery ostium at the wall of aorta (right side, p = 0.436, left side, p = 0.681) did not demonstrate a relationship to renal artery-diaphragmatic crus contact.

Conclusions: Thickness of the diaphragmatic crus and high renal artery origin with respect to superior mesenteric artery are crucial anatomic differences determining the relationship of renal artery and diaphragmatic crus. (Folia Morphol 2018; 77, 1: 22–28)  

Abstract

Background: The aim of this study is to investigate the effect of anatomic differences on the relationship between renal artery and diaphragmatic crus via the touch of two structures. Materials and methods: The study included dynamic computed tomography (CT) scans of 308 patients performed mainly for characterisation of liver and renal masses. Anatomic differences including the thickness of the diaphragmatic crus, the localisation of renal artery ostium at the wall of aorta, the level of renal artery origin with respect to superior mesenteric artery were evaluated. Statistical relationships between renal artery-diaphragmatic crus contact and the anatomic differences were assessed.

Results: Thickness of the diaphragmatic crus at the level of renal artery origin exhibited a statistically significant relationship to renal artery-diaphragmatic crus contact at the left (p < 0.001) and right side (p < 0.001). There was a statistically significant relationship between high renal artery origin and renal artery- -diaphragmatic crus contact at the left (p < 0.001) and right side (p = 0.01). The localisation of renal artery ostium at the wall of aorta (right side, p = 0.436, left side, p = 0.681) did not demonstrate a relationship to renal artery-diaphragmatic crus contact.

Conclusions: Thickness of the diaphragmatic crus and high renal artery origin with respect to superior mesenteric artery are crucial anatomic differences determining the relationship of renal artery and diaphragmatic crus. (Folia Morphol 2018; 77, 1: 22–28)  

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Keywords

entrapment, diaphragmatic crus, renal artery

About this article
Title

The effect of anatomic differences on the relationship between renal artery and diaphragmatic crus

Journal

Folia Morphologica

Issue

Vol 77, No 1 (2018)

Article type

Original article

Pages

22-28

Published online

2017-08-18

Page views

1368

Article views/downloads

1356

DOI

10.5603/FM.a2017.0073

Pubmed

28832087

Bibliographic record

Folia Morphol 2018;77(1):22-28.

Keywords

entrapment
diaphragmatic crus
renal artery

Authors

K. Esen
S. Tok
Yuksel Balci
F. D. Apaydin
E. Kara
D. Uzmansel

References (23)
  1. Anda S, Røysland P, Fougner R, et al. CT appearance of the diaphragm varying with respiratory phase and muscular tension. J Comput Assist Tomogr. 1986; 10(5): 744–745.
  2. Arazińska A, Polguj M, Topol M, et al. Renal artery entrapment - anatomical risk factors rating. Folia Morphol. 2016; 75(4): 486–492.
  3. Brengle M, Cohen MD, Katz B. Normal appearance and size of the diaphragmatic crura in children: CT evaluation. Pediatr Radiol. 1996; 26(11): 811–814.
  4. Caskey CI, Zerhouni EA, Fishman EK, et al. Aging of the diaphragm: a CT study. Radiology. 1989; 171(2): 385–389.
  5. D'abreu Stricland B. Developmental renal-artery stenosis. Lancet. 1962; 2(7255): 517–521.
  6. Déglise S, Corpataux JM, Haller C, et al. Bilateral renal artery entrapment by diaphragmatic crura: a rare cause of renovascular hypertension with a specific management. J Comput Assist Tomogr. 2007; 31(3): 481–484.
  7. Delasotta LA, Olivieri B, Malik A, et al. Thoracic renal artery: a rare variant. A case study and literature review. Surg Radiol Anat. 2015; 37(5): 561–564.
  8. Dovgan DJ, Lenchik L, Kaye AD. Computed tomographic evaluation of maximal diaphragmatic crural thickness. Conn Med. 1994; 58(4): 203–206.
  9. Dure-Smith P, Bloch RD, Fymat AL, et al. Renal artery entrapment by the diaphragmatic crus revealed by helical CT angiography. AJR Am J Roentgenol. 1998; 170(5): 1291–1292.
  10. Gaebel G, Hinterseher I, Saeger HD, et al. Compression of the left renal artery and celiac trunk by diaphragmatic crura. J Vasc Surg. 2009; 50(4): 910–914.
  11. Gupta A, Tello R. Accessory renal arteries are not related to hypertension risk: a review of MR angiography data. AJR Am J Roentgenol. 2004; 182(6): 1521–1524.
  12. Hazırolan T, Öz M, Türkbey B, et al. CT angiography of the renal arteries and veins: normal anatomy and variants. Diagn Interv Radiol. 2011; 17(1): 67–73.
  13. He B, Hamdorf JM. Clinical importance of anatomical variations of renal vasculature during laparoscopic donor nephrectomy. OA Anatomy. 2013; 1(3).
  14. Moes MJ, Filly RA. The neonatal diaphragmatic crura are hypertrophied: a necessary preparation for the first breath? J Ultrasound Med. 2003; 22(7): 715–718.
  15. Moore KL, Persaud T, Torchia MG. Body cavities and diaphragm. In: The developing human: clinically oriented embryology. 9th ed. Philadelphia, Pa: Saunders 2013: 145–158.
  16. Pozzi-Mucelli F, Pellegrin A, Pozzi-Mucelli R. Radiological Imaging of the Kidney. 2nd ed. Springer, Berlin 2014: 189–222.
  17. Restrepo CS, Eraso A, Ocazionez D, et al. The diaphragmatic crura and retrocrural space: normal imaging appearance, variants, and pathologic conditions. Radiographics. 2008; 28(5): 1289–1305.
  18. Saba L, Sanfilippo R, Montisci R, et al. Accessory renal artery stenosis and hypertension: are these correlated? Evaluation using multidetector-row computed tomographic angiography. Acta Radiol. 2008; 49(3): 278–284.
  19. Shruthi BN. Unilateral entrapment of the renal artery by diaphragmatic crus. Natl J Med Res. 2013; 3: 412–413.
  20. Silver D, Clements JB. Renovascular hypertension from renal artery compression by congenital bands. Ann Surg. 1976; 183(2): 161–166.
  21. Singham S, Murugasu P, Macintosh J, et al. Left main renal artery entrapment by diaphragmatic crura: spiral CT angiography. Biomed Imaging Interv J. 2010; 6(2): e11.
  22. Spies JB, LeQuire MH, Robison JG, et al. Renovascular hypertension caused by compression of the renal artery by the diaphragmatic crus. AJR Am J Roentgenol. 1987; 149(6): 1195–1196.
  23. Thony F, Baguet JP, Rodiere M, et al. Renal artery entrapment by the diaphragmatic crus. Eur Radiol. 2005; 15(9): 1841–1849.

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