Research Article
Evaluation of Renal Arterial Anatomy in Horseshoe Kidney Using Contrast-Enhanced Computed Tomography (CECT)
Abhighna G1*, Vidhyarani R2, Kushal M3 and Anughna G1
1Junior Resident, Department of Radio diagnosis, Sapthagiri Institute of Medical Sciences, Bengaluru, Karnataka, India
2Professor, Department of Radio diagnosis, Department of Radio diagnosis, Sapthagiri Institute of Medical Sciences, Bengaluru, Karnataka, India
3Senior resident, Department of Radio diagnosis, Sapthagiri Institute of Medical Sciences, Bengaluru, Karnataka, India
2Professor, Department of Radio diagnosis, Department of Radio diagnosis, Sapthagiri Institute of Medical Sciences, Bengaluru, Karnataka, India
3Senior resident, Department of Radio diagnosis, Sapthagiri Institute of Medical Sciences, Bengaluru, Karnataka, India
*Corresponding author:Dr. Abhighna G, Department of Radio diagnosis, Sapthagiri Institute of Medical Sciences, Bengaluru, Karnataka, India. E-mail id: abhighnag98@gmail.com
Copyright: © 2026 Abhighna G, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Article Information:Submission: 27/05/2026; Accepted: 01/09/2026; Published: 05/09/2026
Abstract
Background: Horseshoe kidney (HSK) is one of the most common congenital renal fusion anomalies, characterized by fusion of the lower poles of both kidneys, with an estimated prevalence of 0.25–0.5%.[1] Vascular abnormalities, particularly involving the renal arteries, are frequently associated with this condition and may complicate surgical planning, kidney transplantation, and interventional procedures [2,3]
Objective: This study aims to evaluate the renal artery anatomy in patients with HSK using contrast-enhanced computed tomography (CT) imaging.
Materials and Methods: A prospective analysis of 10 patients diagnosed with HSK was conducted using multi-phase contrast-enhanced CT imaging. Renal arterial variations in number, origin, and course, along with their relationship to the anatomical features of horseshoe kidneys, were systematically examined and analyzed using descriptive statistics to report the incidence of specific variations.
Results: Among the 10 patients evaluated, substantial variability in renal arterial anatomy was demonstrated on contrast-enhanced CT. According to the Graves classification, Pattern II was the most frequent arterial configuration (4/10, 40%), followed by Pattern III (3/10, 30%). Pattern I, Pattern V, and Pattern VI were each observed in 1 patient (10%), while Pattern IV was not identified. Multiple accessory renal arteries were documented in 5 patients (50%), early or late branching in 3 patients (30%), anomalous arterial origin in 1 patient (10%), and normal arterial anatomy in 1 patient (10%). Distinct arterial supply to the renal isthmus was demonstrated in few patients, including vessels arising from the anterior abdominal aorta and the common iliac artery.
Conclusion: Computed tomography offers a highly effective tool for evaluating renal artery variations in horseshoe kidneys, facilitating accurate diagnosis and preoperative planning. Recognition of these variations is crucial for optimizing management strategies in both nephrectomy and renal transplantation procedures.
Objective: This study aims to evaluate the renal artery anatomy in patients with HSK using contrast-enhanced computed tomography (CT) imaging.
Materials and Methods: A prospective analysis of 10 patients diagnosed with HSK was conducted using multi-phase contrast-enhanced CT imaging. Renal arterial variations in number, origin, and course, along with their relationship to the anatomical features of horseshoe kidneys, were systematically examined and analyzed using descriptive statistics to report the incidence of specific variations.
Results: Among the 10 patients evaluated, substantial variability in renal arterial anatomy was demonstrated on contrast-enhanced CT. According to the Graves classification, Pattern II was the most frequent arterial configuration (4/10, 40%), followed by Pattern III (3/10, 30%). Pattern I, Pattern V, and Pattern VI were each observed in 1 patient (10%), while Pattern IV was not identified. Multiple accessory renal arteries were documented in 5 patients (50%), early or late branching in 3 patients (30%), anomalous arterial origin in 1 patient (10%), and normal arterial anatomy in 1 patient (10%). Distinct arterial supply to the renal isthmus was demonstrated in few patients, including vessels arising from the anterior abdominal aorta and the common iliac artery.
Conclusion: Computed tomography offers a highly effective tool for evaluating renal artery variations in horseshoe kidneys, facilitating accurate diagnosis and preoperative planning. Recognition of these variations is crucial for optimizing management strategies in both nephrectomy and renal transplantation procedures.
Keywords:Horseshoe Kidney, Renal Artery Variations, Accessory Renal Arteries, Congenital Renal Anomalies, Renal Vascular Anatomy, Multi-Phase Contrast-Enhanced CT, Renal Vascular Anomalies, Vascular Anatomy, Renal Fusion Anomalies