Helical (spiral) CT angiography for identification of crossing vessels at the ureteropelvic junction.

Quillin, S P; Brink, James A.; Heiken, Jay P.; Siegel, Cary; McClennan, Bruce L.; Clayman, Ralph V.

doi:10.2214/ajr.166.5.8615256

Cited by 85 publications

(27 citation statements)

References 18 publications

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“…Macroscopic surgical findings were reported to be in agreement with helical CT angiography findings in 91-100% of patients who had pyeloplasty [22][23][24]. In the present patients, crossing vessels detected by CT were confirmed in 32 of 33 during pyeloplasty.…”

Section: Discussionsupporting

confidence: 85%

Role of multiphasic helical computed tomography in planning surgical treatment for pelvi‐ureteric junction obstruction

et al. 2004

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OBJECTIVETo evaluate the role of multiphasic helical computed tomography (CT) in planning surgical treatment for pelvi‐ureteric junction obstruction (PUJO).PATIENTS AND METHODSMultiphasic helical CT was used in 60 consecutive patients (mean age 32 years, sd 13.72) with primary PUJO. The different images were interpreted before surgery by a urologist and radiologist. The number, type and relation of the crossing vessels to the PUJ were detected. Pyeloplasty (open or laparoscopic) was used in patients where there was a significant crossing vessel (i.e. > 2 mm in diameter and passing at the PUJ) or with ballooning of the renal pelvis. Endopyelotomy (antegrade or retrograde) was used in the other patients. Subjective and objective success rates were determined 3–6 months after treatment and then every 6 months.RESULTSHyperdense renal stones were detected in precontrast images in 15 patients, significant crossing vessels in 33 (55%), and anterior malrotation of the renal pelvis in 23 (38%; 19 associated with significant crossing vessels, i.e. ureterovascular hydronephrosis). A large para‐pelvic cyst compressing the PUJ and upper ureter was detected in one patient. Pyeloplasty was used in 45 patients, among whom the sensitivity of multiphasic helical CT in detecting crossing vessels was 97%, the specificity 92% and accuracy 96%. Uncomplicated endopyelotomy was used in 14 patients and percutaneous aspiration of the para‐pelvic cyst in one.CONCLUSIONMultiphasic helical CT can accurately delineate the spatial anatomy of the renal and peri‐renal area; it may be important in planning surgical treatment for PUJO, especially when endopyelotomy is considered.

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Section: Discussionsupporting

confidence: 85%

Role of multiphasic helical computed tomography in planning surgical treatment for pelvi‐ureteric junction obstruction

et al. 2004

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“…Previous anatomic investigations have shown that vessels have a close relation to the UPJ in approximately 75% of patients with the syndrome. 3,4,8,9 This rate was confirmed here, with 63% of the present series exhibiting an inferior-pole pedicle.…”

Section: Treatment Of Upj Obstructionsupporting

confidence: 85%

“…These advantages have enhanced the imaging of small vessels. 3,4,8,11,12 In our study, all the arteries observed during the laparoscopic approach were detected by MDCT. Classically, digital subtraction angiography (DSA) with selective injections is considered to be the standard of reference in depicting polar arteries.…”

Section: Accuracy Of Mdctmentioning

confidence: 69%

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Vascular Renal Anatomy and the Ureteropelvic Junction: Preoperative Multidetector CT Scanning with Split-Bolus Injection as a Predictor of Laparoscopic Findings

Sauer¹,

Flocquet²,

Batch³

et al. 2008

Journal of Endourology

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Purpose:To compare multidetector CT scan (MDCT) results with intraoperative findings in the detection of an inferior-pole pedicle crossing the ureteropelvic junction.Patients and Methods: Over the 2-year study period, 35 patients receiving laparoscopic pyeloplasty underwent preoperative investigation with a novel MDCT protocol in order to detect crossing vessels. Postprocessing, including maximum intensity projection, volume-rendering technique, and multiplanar reconstruction, was used in addition to standard axial views.Results: All the arteries found during laparoscopic surgery were detected by MDCT, but one radiologic false-positive was noted at the beginning of the series. Seven veins were not detected with MDCT. In the only case featuring an isolated inferior-pole vein, the aberrant vessel was identified by MDCT.Conclusion: Multidetector CT scanning is a highly accurate way of providing all the information necessary preoperatively concerning renal parenchymal anomalies, urinary stones, and collecting system and vessel anatomy. It helps physicians make appropriate therapeutic decisions and gives surgeons information about what they can expect during laparoscopic procedures.

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“…DTPA is performed to assess the degree of obstruction and split renal function. CT is helpful in demonstrating the crossing vessels before surgical planning [41] (Figure 17). Depending on the degree of obstruction and residual function, surgery is often performed in the form of pyeloplasty or stenting.…”

mentioning

confidence: 99%

Multi-modality imaging review of congenital abnormalities of kidney and upper urinary tract

Ramanathan¹,

Kumar²,

Khanna³

et al. 2016

WJR

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Congenital abnormalities of the kidney and urinary tract (CAKUT) include a wide range of abnormalities ranging from asymptomatic ectopic kidneys to life threatening renal agenesis (bilateral). Many of them are detected in the antenatal or immediate postnatal with a significant proportion identified in the adult population with varying degree of severity. CAKUT can be classified on embryological basis in to abnormalities in the renal parenchymal development, aberrant embryonic migration and abnormalities of the collecting system. Renal parenchymal abnormalities include multi cystic dysplastic kidneys, renal hypoplasia, number (agenesis or supernumerary), shape and cystic renal diseases. Aberrant embryonic migration encompasses abnormal location and fusion anomalies. Collecting system abnormalities include duplex kidneys and Pelvi ureteric junction obstruction. Ultrasonography (US) is typically the first imaging performed as it is easily available, noninvasive and radiation free used both antenatally and postnatally. Computed tomography (CT) and magnetic resonance imaging (MRI) are useful to confirm the ultrasound detected abnormality, detection of complex malformations, demonstration of collecting system and vascular anatomy and more importantly for early detection of complications like renal calculi, infection and malignancies. As CAKUT are one of the leading causes of end stage renal disease, it is important for the radiologists to be familiar with the varying imaging appearances of CAKUT on US, CT and MRI, thereby helping in prompt diagnosis and optimal management.

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Helical (spiral) CT angiography for identification of crossing vessels at the ureteropelvic junction.

Cited by 85 publications

References 18 publications

Role of multiphasic helical computed tomography in planning surgical treatment for pelvi‐ureteric junction obstruction

Role of multiphasic helical computed tomography in planning surgical treatment for pelvi‐ureteric junction obstruction

Vascular Renal Anatomy and the Ureteropelvic Junction: Preoperative Multidetector CT Scanning with Split-Bolus Injection as a Predictor of Laparoscopic Findings

Multi-modality imaging review of congenital abnormalities of kidney and upper urinary tract

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