THREE-DIMENSIONAL QUANTITATIVE ANALYSIS OF THE ARTERIAL AND VENOUS BED OF THE KIDNEY FOR DETECTION OF ARTERIAL BLOOD SUPPLY AND VENOUS OUTFLOW AREAS IN THE PARENCHYMA IN THE DICHOTOMOUS RENAL ARTERY DIVISION

The objective of the study was to conduct a three-dimensional quantitative analysis of the arterial and venous bed of the kidney with the identification of areas of arterial blood supply and venous outflow in the parenchyma in the dichotomous variant of renal artery division.

The material for the study was 124 polychrome corrosion specimens of arterial and venous vessels of the human kidneys, which were subjected to 3D scanning followed by a three-dimensional analysis of the vascular bed of the kidney. Scanogram data were imported into special modules of IntelliSpase Portal and Synapse 3D workstations for automatic calculation of the volume of vascular beds.

Results and discussion. Dichotomous and trichotomous variants of division of the main renal artery in relation to the frontal, sagittal and horizontal plane into vessels of the 2nd order were determined, that is, zonal arteries - “A. (zonal)» (II) which form certain arterial pools in the parenchyma of the organ, consisting of 3 groups. The first group included kidneys with a dichotomous division of the main renal artery in relation to the frontal plane, forming 2 arterial pools in the ventral and dorsal half of the kidney (that is, with a dual-zone blood supply), which amounted to 11 variants (51.8%). The second group consisted of kidneys with a dichotomous variant of division, forming arterial pools in the parenchyma of the upper and lower poles of the kidney, which included 4 variants (27.1%).

Conclusions. It has been found that the sources of blood supply to the zones of the kidneys, that is, the number of zonal arteries, have their own differences depending on the variants of division of the main renal artery and the types of branching of its intraorgan arterial vessels. The number of venous vessels involved in the drainage of various zones of the kidney and the places of their confluence at the level of the links of the main venous vessels depend on the variants and types of vein fusion in its intraorgan venous bed.

1. Azmi Makhmud. Venoznoe ruslo i ego sintopicheskie vzaimootnosheniya s arteriyami pochek cheloveka / Azmi Makhmud, Ali Khussein // Meditsina s'ogodnі і zavtra. – 2008. – № 2. – S. 101-104.

2. Alyaev, Yu.G. «Malen'kaya» opukhol' pochki / Yu.G. Alyaev, A.A. Krapivin, N.I. Al' Agbar // Urologiya. – 2002. – № 2. – S. 3-7.

3. Gubarev, K.K. Osobennosti podgotovki mochetochnika pri transplantatsii pochki v zavisimosti ot variantov raspolozheniya mochetochnikovoi veny pri raznykh tipakh formirovaniya pochechnykh ven / K.K. Gubarev, V.V. Musokhranov, M.V. Borisenko // Omskii nauchnyi vestnik. – 2006. – S3–3. – S. 331-334.

4. Kvyatkovskaya, T.A. Anatomo-sonograficheskoe sopostavlenie morfometricheskikh dannykh pochechnykh sosudov i ikh vnutriorgannykh vervei / T.A. Kvyatkovskaya, E.Kh. Chernyavskii, T.L. Kutsak // Rossiiskie morfologicheskie vedomosti. – 2000. – № 1/2. ‒ S. 201-202.

5. Mochalov O. Individual'naya izmenchivost' arkhitektoniki krovenosnykh sosudov pochki : dis. … kand. med. nauk / O. Mochalov. – Kishineu, 2006. – 164 s.

6. Obysov A.S. Nadezhnost' biologicheskikh tkanei / A.S. Obysov. – M.: Meditsina, 1971. – 104 s.

7. Bluth E.I. Ultrasonography in Urology: A Practical Approach to Clinical Problems / E.I. Bluth, C.B. Benson. – 2nd ed. – Thieme, 2007. – 192 p. – ISBN-13978-1588906090.

8. Graf N. The role of preoperative chemotherapy in the management of Wilms' tumor. The SIOP studies. International Society of Pediatric Oncology / N. Graf, M.F. Tournade, de J. Kraker // Urol. Clin. North. Am. – 2000. – Vol. 27, N 3. – P. 443-454.

9. Habrand J.L. Un siècle de progrès dans la connaissance et le traitement du néphroblastome / J.L. Habrand, F. Pein, V. Moncho // Cancer Radiother. – 2000. – Vol. 4, Suppl. 1. – P. 154s-161s.

10. Magnetic resonance angiography for the diagnosis of renal artery stenosis: a meta-analysis / K.T. Tan, E.J. van Beek, P.W. Brown [et al.] // Clin. Radiol. – 2002. – Vol. 57, N 7. – P. 617-624.

11. Renal function outcomes in patients treated with nephron sparing surgery for bilateral Wilms tumor / D.W. Giel, M.A. Williams, D.P. Jones [et al.] // J. Urol. – 2007. – Vol. 178, N 4, Pt. 2. – P. 1786-1789.