Radiological Case

Incidental Renal Arteriovenous Malformation

Omar Daher, MD; Niharika Shahi, BS; David Kisselgoff, MD; Anatoly Shuster, MD


Appl Radiol. 2021;50(3):47-49. 

In This Article

Imaging Findings

Contrast-enhanced CT of the abdomen and pelvis to evaluate the cecal mass demonstrated an incidental large, left renal arteriovenous malformation (AVM) (Figure 1). Subsequent multiphasic CT examination dedicated to the kidneys (including arterial and venous phases) was conducted with coronal and sagittal reformations (Figure 2). The left main renal artery was significantly enlarged and tortuous, measuring up to 9.6 mm in maximal cross-sectional diameter.

Figure 1.

CT axial images in arterial (A) and portal (B) phases and coronal arterial (C) and venous (D) phases showing the incidental large left renal AVM.

Figure 2.

Maximum intensity projection coronal image showing large left renal AVM.

The left kidney was found to have a complex arterial supply, including two arterial branches to the upper pole of the kidney, one arterial branch to the interpolar region, and an accessory renal artery arising from the abdominal aorta and supplying the lower pole.

The renal AVM showed direct communication between the arterial circulation and markedly dilated draining venous structures within the renal sinus as well as multiple venous lobulations with vermiform appearance at the periphery. The left kidney also demonstrated mild hydronephrosis.