Evaluation of left renal vein and IVC variations in MDCT examinations performed in patients with a preliminary diagnosis of renal calculi

Evaluation of left renal vein and IVC variations in MDCT



inferior vena cava, left renal veins, renal stone disease, computed tomography, retroaortic, circumaortic


Background/Aim: Left renal vein (LRV) and inferior vena cava (IVC) variations are not rare, an observation that is extremely important to understanding the presence of these structures before performing surgery. This study aimed to evaluate the type and frequency of IVC and LRV variations with multi-detector computer tomography (MDCT) in patients admitted with a preliminary diagnosis of renal calculi and to evaluate the relationship of these variations with renal calculi, renal cysts, and horseshoe kidneys.

Methods: We retrospectively analyzed 1640 patients who underwent abdominal CT for suspicious renal calculi between January 2018 and December 2019. This retrospective cohort study consisted of 1604 patients after the exclusion criteria. Renal surgery and/or renal agenesis examinations without enough diagnostic quality due to motion artifacts were considered the exclusion criteria. Age, gender, presence and types of IVC and renal variations, and presence of renal calculi, renal cysts, and horseshoe kidney were recorded. The relationship between variation types and presence of renal calculi, renal cysts, and horseshoe kidneys was evaluated.

Results: IVC and LRV variations were detected in 107 patients (6.7%). The prevalence of circumaortic LRV (CLRV) and retroaortic LRV (RLRV), left IVC, and double IVC in 65 patients was 4.1%, 2.4%, 0.1%, and 0.1%, respectively. Male gender predominance in both total and RLRV were found in the variations (P=0.033 and P=0.033, respectively). Urinary calculi were found in 1016 (63.3%) of the patients, kidney cysts in 247 (15.4%), and horseshoe kidneys in 10 (0.6%). No correlation between the presence of renal calculi, kidney cysts, and horseshoe kidney and the presence of variations in patients with LRV was found (P=0.433, P=0.215, and P=0.500, respectively).

Conclusions: LRV and IVC variations are not uncommon. It is necessary to be informed about these variations before performing retroperitoneal surgery to prevent possible complications. LRV and IVC variations can be easily recognized in pre-diagnosed renal calculi on MDCT without the use of an intravenous contrast agent.


Download data is not yet available.


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. doi: 10.2399/ana.08.072. DOI: https://doi.org/10.2399/ana.08.072

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. 2012;73(2):159-63. doi: 10.5603/FM.2014.0017. DOI: https://doi.org/10.5603/FM.2014.0017

Dilli A, Ayaz UY, Karabacak OR, Tatar IG, Hekimoglu B. Study of the left renal variations by means of magnetic resonance imaging. Surg Radiol Anat. 2012;34:267-70. doi: 10.1007/s00276-011-0833-7. DOI: https://doi.org/10.1007/s00276-011-0833-7

Koc Z, Ulusan S, Oguzkurt L, Tokmak N. Venous variants and anomalies on routine abdominal multi-detector row CT. Eur J Radiol. 2007;61(2):267-78. doi: 10.1016/j.ejrad.2006.09.008. DOI: https://doi.org/10.1016/j.ejrad.2006.09.008

Aslan S, Çakır İM. Evaluation of the incidence of renal vein anomalies and their relationship with renal stone disease and renal tumors by abdominal multidetector computed tomography. Cukurova Med J. 2022;47(1):292-300. doi: 10.17826/cumj.1031806. DOI: https://doi.org/10.17826/cumj.1031806

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. doi: 10.1016/j.transproceed.2011.03.069. DOI: https://doi.org/10.1016/j.transproceed.2011.03.069

Ozgul E. Evaluating incidence and clinical importance of renal vein anomalies with routine abdominal multidetector computed tomography. Abdom Radiol. 2021;46:1034-40. doi: 10.1007/s00261-020-02716-y. DOI: https://doi.org/10.1007/s00261-020-02716-y

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(2):278-82. doi: 10.1016/j.ygyno.2004.09.056. DOI: https://doi.org/10.1016/j.ygyno.2004.09.056

Tore HG, Tatar I, Celik HH, Oto A, Aldur MM, Denk CC. Two cases of inferior vena cava duplication with their CT findings and a review of the literature. Folia Morphol. 2005;64(1):55-8.

Bass JE, Redwine MD, Kramer LA, Huynh PT, Harris JH. Spectrum of congenital anomalies of the inferior vena cava: cross-sectional imaging findings. Radiographics. 2000;20(3):639-52. doi: 10.1148/radiographics.20.3.g00ma09639. DOI: https://doi.org/10.1148/radiographics.20.3.g00ma09639

Dilli A, Ayaz UY, Kaplanoglu H, Saltas H and Hekimoglu B. Evaluation of the renal vein variations and inferior vena cava variations by means of helical computed tomography. Clinical imaging. 2013;37:530-5. doi: 10.1016/j.clinimag.2012.09.012. DOI: https://doi.org/10.1016/j.clinimag.2012.09.012

Şahin C, Kitiki Ö, Kaçira, Tüney D. The retroaortic left renal vein abnormalities in cross-sectional imaging. Folia Medica. 2014;56(1):38-42. doi: 10.2478/folmed-2014-0006. DOI: https://doi.org/10.2478/folmed-2014-0006

Ayaz S, Ayaz UY. Detection of retroaortic left renal vein and circumaortic left renal vein by PET/CT images to avoid misdiagnosis and support possible surgical procedures. Hell J Nucl Med. 2016;19(2):1359. doi: 10.1967/s002449910367.

Yesildag A, Adanir E, Köroglu M, Baykal B, Oyar O, Gülsoy UK. Incidence of left renal vein anomalies in routine abdominal CT scans. Tani Girisim Radyol. 2004;10(2):140-3.

Nam JK, Park SW, Lee SD, Chung MK. The clinical significance of a retroaortic left renal vein. Korean J Urol 2010;51(4):276-80. doi: 10.4111/kju.2010.51.4.276. DOI: https://doi.org/10.4111/kju.2010.51.4.276

Dilli A, Sevin F, Ayaz C, Karacan K, Zengin K, Ayaz ÜY, et al. Evaluation of renal anomalies, inferior vena cava variations, and left renal vein variations by lumbar magnetic resonance imaging in 3000 patients. Turk J Med Sci. 2017;47:1866-73. doi: 10.3906/sag-1611-23. DOI: https://doi.org/10.3906/sag-1611-23

Jaffer F, Chandiramani V. Concomitant persistent left superior vena cava and horseshoe kidney. Case Rep Nephrol. 2015;2015:178310. doi: 10.1155/2015/178310. DOI: https://doi.org/10.1155/2015/178310

Leblebisatan Ş, Gulek B, Soker G. Vena Cava and Left Renal Vein Variations and Association with Other Anomalies Including Horseshoe Kidney. Iranian Journal of Radiology. 2019:16(1);e79503. doi: 10.5812/iranjradiol.79503. DOI: https://doi.org/10.5812/iranjradiol.79503

Ichikawa T, Kawada S, Koizumi J, Endo J, Itou C, Matsuura K, et al. Anomalous inferior vena cava associated with horseshoe kidney on multidetector computed tomography. Clinical Imaging. 2013:37(5):889-94. doi: 10.1016/j.clinimag.2013.03.005. DOI: https://doi.org/10.1016/j.clinimag.2013.03.005

Ichikawa T, Kawada S, Koizumi J, Endo J, Lino M, Terachi T, et al. Major venous anomalies are frequently associated with horseshoe kidneys. Circ J. 2011;75(12):2872-7. doi: 10.1253/circj.cj-11-0613. DOI: https://doi.org/10.1253/circj.CJ-11-0613






Research Article

How to Cite

Yılmaz BK, Diker M, Aslan S, Atasoy B, Karahasanoglu R, Gocgun N, Ozdemir S, Turkay R. Evaluation of left renal vein and IVC variations in MDCT examinations performed in patients with a preliminary diagnosis of renal calculi : Evaluation of left renal vein and IVC variations in MDCT. J Surg Med [Internet]. 2023 Jan. 31 [cited 2023 Jun. 4];7(1):128-32. Available from: https://jsurgmed.com/article/view/7681