Evaluation of morphologic features of testicular arteries BY multidetector CT angiography

The aim of our study is to determine whether multislice computerized tomography angiography (MDCTA) is a suitable method for the evaluation of testicular arteries (TA) and to establish a new classification system by detecting the number, origin, and course of testicular arteries. BTA images of 732 patients were retrospectively screened for this purpose and 400 (55%) were evaluated as diagnostic. On a total of 800 sides; 777 (97%) side had single TA, and 22 (2.75%) side had double TA. Bilateral double TA was observed in 2 patients (0.5%). The TA was not observed on one side (0.25%) of a patient. According to the proposed classification system Types are as follows: Based on the origin; Type 1: TA originating from the abdominal aorta (AA), superior to the renal artery (RA) level. Type 2: TA originating from the AA, at the RA level. Type 3: TA originating from the renal, segmental renal, accessory renal or middle suprarenal artery. Type 4: Testicular artery originating from the abdominal aorta, inferior to the renal artery level (Normal origin). Type 5: TA originating from the AA, more than 5 cm inferior to the RA level or closer to the aortic bifurcation of the distance between the aortic bifurcation and the RA. Based on the course: Type a: Normal course. Type b: Course through posterior to the vena cava inferior. Type c: Testicular artery arcing over all or part of the renal pedicle. The most common types of TA according to the origin and course were; 532 (% 64,8) Type 4a, 61 (7,4%) Type 3a, 40 (4,9%) Type 2c, 38 (4,6% ) Type 5a, 34 (% 4,1) Type 4b, and 30 (3.7%) Type 4c. In conclusion, CTA may be a suitable test for TA evaluation in selected cases, and the TA evaluation by the classification we have developed may give valuable information for retroperitoneal surgeries, vascular interventional procedures, and for the clinical scenarios like varicocele. Keywords: CT Angiography, testicular artery, testicular artery classification.