| Helical (spiral) CT angiography for identification of crossing vessels at the ureteropelvic junction. | |
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MedLine Citation:
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PMID: 8615256 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The purpose of this study was to determine the feasibility of imaging crossing vessels at the ureteropelvic junction (UPJ) with helical (spiral) CT angiography for planning surgical repair of symptomatic UPJ obstruction. SUBJECTS AND METHODS: Twenty-four consecutive patients with symptomatic UPJ obstruction were imaged with dual-phase, contrast-enhanced helical CT (collimation, 3 mm; pitch, 1.3-1.7; reconstruction interval, 2 mm; early phase, 20-42 sec; and delayed phase, 90-112 sec after initiation of IV contract material injection [125 ml of ioversol containing 320 mg of iodine per ml, delivered at 4-5 ml/sec]). All imaging data were viewed interactively on an imaging workstation. Prospective on-line interpretations were correlated with subsequent surgical and clinical findings at laparoscopy (n=3), open surgical repair (n=2), or ureteronephroscopic endopyelotomy (n=11). Vessels at the UPJ that were 2 mm or more in diameter were believed to be significant. Review of the transaxial images was performed to determine qualitatively the relative usefulness of the early versus the delayed phases for distinguishing arteries from veins. Multiplanar reformations also were retrospectively reviewed and compared with direct pyelograms to determine the accuracy with which the location of the UPJ and the proximal ureteral course were depicted with helical CT. RESULTS: Eleven of 24 (46%) patients collectively had 11 anterior and three posterior vessels (> or = 2 mm in diameter) crossing the UPJ on helical CT. Distinction between arteries and veins was significantly better on early-phase than on delayed-phase images (p=.01). Visualization of the UPJ and the proximal ureteral course was good or excellent for 18 (78%) of 23 patients for whom pyelograms were available, regardless of the presence of a ureteral stent (p>.05). Laparoscopy and open surgery findings were in agreement with helical CT angiograms for five of five patients. Uncomplicated endopyelotomy was performed for 11 patients in whom no significant vessels were seen posterior or posterolateral to the UPJ. CONCLUSION: Helical CT angiography can depict vessels crossing the UPJ and is valuable in planning surgical management. |
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Authors:
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S P Quillin; J A Brink; J P Heiken; C L Siegel; B L McClennan; R V Clayman |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: AJR. American journal of roentgenology Volume: 166 ISSN: 0361-803X ISO Abbreviation: AJR Am J Roentgenol Publication Date: 1996 May |
Date Detail:
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Created Date: 1996-06-06 Completed Date: 1996-06-06 Revised Date: 2010-03-24 |
Medline Journal Info:
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Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1125-30 Citation Subset: AIM; IM |
Affiliation:
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Mallinckrodt Institute of Radiology, St. Louis, MO 63110, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Angiography / instrumentation, methods Contrast Media / administration & dosage Feasibility Studies Female Humans Kidney Pelvis / blood supply, radiography*, surgery Male Middle Aged Patient Care Planning Prospective Studies Retrospective Studies Tomography, X-Ray Computed / instrumentation, methods* Ureter / blood supply, radiography*, surgery Ureteral Obstruction / radiography, surgery |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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