BACKGROUND: This study was conducted to analyze the height and width of the pedicle of the upper and lower levels on the concave and the convex sides. In addition, we checked for the appropriate pedicle screw size which could be screwed in without complications. MATERIALS AND METHODS: Taking a simple AP radiography in a standing position, 99 vertebrae on the major curve with the possibility of 3-D reconstruction were analyzed after checking the CT in a supine position of 22 idiopathic scoliosis. We measured Cobb's angle from a simple radiograph, and measured the size of the isthmus by the Inner Space 3-D Editor after 3-D reconstruction with the Inner Space 3-D program in the DICOM file transformed from CT image. We then analyzed the size of pedicles of the upper and lower levels on the concave and the convex sides by measuring the height and width of the pedicle. RESULTS: All pedicles on the concave side were smaller than those on the convex side. Their size increased as the measurement moved from the upper to lower vertebra, except for the upper thoracic vertebra. When the width of the pedicle through 3-D reconstruction was compared with the narrowest width of the pedicle measured by using CT, the width of the pedicles through 3-D reconstruction was statistically smaller (P< 0.01). Most of the pedicles were tear-drop or kidney shaped rather than cylindrical. CONCLUSION: These results suggest that the use of the coronal plane through 3-D reconstruction would be necessary for an accurate measurement of the size of the pedicle. It is important to pay careful attention to the screw size and the screwing method considering the pedicle shape through 3-D reconstruction.
Kidney ; Radiography ; Scoliosis* ; Spine ; Supine Position

Anomalies of renal vasculature combined with ectopic kidneys were found on a multi-detector CT scan. Knowledge of renal vascular variation is very important for surgical exploration, radiologic intervention and staging for urologic cancer. We present an extremely rare case of a right circumaortic renal vein combined with a right ectopic kidney. The right kidney was located at the level between the third and fifth lumbar vertebra. The right circumaortic renal vein crossed the aorta and returned to the inferior vena cava behind the aorta.
Adult ; Humans ; Kidney/*abnormalities/blood supply/radiography ; Kidney Diseases/congenital/*radiography ; Male ; *Multidetector Computed Tomography ; Renal Veins/*abnormalities/radiography ; Vena Cava, Inferior/abnormalities/radiography

Complete surgical removal of staghorn or multiple renal calculi is very difficult. So, intraoperative radiography for localization of renal calculi has been used to decrease the incidence of residual calculi We herein assess the effectiveness of intraoperative radiography using renal contact chassis introduced by Gil-Vernet. The images are enough to remove the residual stones and there is minimal radiation exposure to the patient and staff of the operating room. We removed all renal stones completely in 2 operations.
Calculi ; Humans ; Incidence ; Kidney Calculi* ; Operating Rooms ; Radiography*

Intrathoracic ectopia denotes either a partial or a complete protrusion of the kidney above the diaphragm into the postecioc mediastinum and is a very rare developmental anomaly. The vast majority of patient with this anomaly has remained asymptomatic but discovered on routine chest radiographs. The diagnosis is made following a routine chest X-ray, lateral chest film and excretory urography. Herein we report a case of intrathoracic kidney which was found incidentally during the routine check-up and normal function of kidney.
Diagnosis ; Diaphragm ; Humans ; Kidney* ; Mediastinum ; Radiography, Thoracic ; Thorax ; Urography

Congenital thoracic ectopic kidney is a very rare developmental disorder and the rarest type of ectopic kidney. This condition is usually asymptomatic and detected incidentally on routine chest radiography. Most cases of thoracic ectopic kidney develop in adulthood and during the neonatal period, and congenital thoracic ectopic kidney rarely develops in children. Most patients are asymptomatic, and the treatment depends on the diagnosis. Herein, we report a rare case of ectopic thoracic kidney associated with a diaphragmatic hernia in a 15-month-old male infant, who presented with periodic severe irritability. The thoracic ectopic kidney was detected as a mass in the right base of the chest on routine chest radiography.
Child ; Diagnosis ; Hernia, Diaphragmatic* ; Humans ; Infant* ; Kidney* ; Male ; Radiography ; Thorax

The authors describe a case in which a tailgut cyst occurred at an unusual location in a 22-year-old woman referred for abdominal discomfort and urinary frequency. The left abdomen contained a palpable mass, found at imaging studies to be a homogeneous, unilocular and cystic, and anterior to the left kidney. After surgical excision, it was shown to be a tailgut cyst.
Adult ; Case Report ; Female ; Hamartoma/*radiography/surgery ; Human ; Kidney Diseases/*radiography/surgery ; Retroperitoneal Space

The lateral margin of the psoas muscle, contrasted by retroperitoneal fat, is usually visualized o plainabdominal radiography. Failure to visualize all or segment of lateral margin of the psoas muscle, so called psoassing, has been emphasized as reliable finding of retroperitoneal pathology. But the significance of psoas sign hasbeen controversial. The authors reevaluated ‘psoas sign’ by comparing 160 abdominal radiography with CT. Theresults were as follows: 1. In 160 supine radiographys, good visualization was present in 106 cases(66.3%), faintvisualizatin in 24(15.0%), segmental nonvisualization in 18(11.3%), and completer nonvisualization in 12(7.5%). In113 erect radiographs, good visualization was present in only 36 cases(31.9%). 2. Asymmetric visualization waspresent in 84 out of 160 cases. In patient with scoliosis, lateral margin of convex side was seen more clearlythan concave side, and this finding was statistically significant (p<0.005). 3. Ascites did not directly influenceto psoa visualization contrary to common belief. 4. In 54 cases of faint or nonvisualization, normal was16(29.6%), intraperitoneal pathology was 16(29.6%), and retroperitoneal pathology was 22(40.7%). 1) In normalpatient, psoas contact with kidney or intestine and deformed psoas muscle were responsible for poor visualization. 2) The major cause of poor visualization in intraperitoneal pathology were psoas contact with displaced kidney byhepatomegaly, ascites with scanty retroperitoneal fat and derformed psaos muscle. 3) The major cause of poorvisualization in retroperitoneal pathology were psoas invasion by tumor or inflammation, psoas conntact withenlarged kidney or perirenal lesion. 5. In summary, the mechanism of faint or nonvisualization of psoas marginwere: 1) psoas contact with normal or pathologic organs 2) psoas invasion by tumor or inflammation 3) deformedpsoas muscle 4) scanty retroperitoneal fat
Ascites ; Humans ; Inflammation ; Intestines ; Intra-Abdominal Fat ; Kidney ; Pathology ; Psoas Muscles ; Radiography ; Radiography, Abdominal ; Scoliosis

A 74-yr-old woman presented with fever and abdominal discomfort. She was in a septic condition caused by urinary tract infection. Her computed tomogram of the abdomen revealed features of hydronephrosis with ureteral stones in both kidneys. During percutaneous nephrostomies, right pyeloduodenal fistula (PDF) was diagnosed. Elective surgery was originally planned but the patient was in a poor condition to undergo surgery. Instead, 2 times endoscopic clipping and ligation by endoloop were applied with parenteral antibiotics for the fistula lesion. On admission day 30, she was discharged from the hospital after confirmation of no more contrast leakage on fistulography. We reviewed the literature and discuss the etiologies, clinical presentations, diagnosis, and treatment of PDF.
Aged ; Duodenal Diseases/complications/radiography/*surgery ; Female ; Humans ; Hydronephrosis/complications/radiography ; Intestinal Fistula/complications/radiography/*surgery ; Kidney/radiography/surgery ; Kidney Calculi/complications/radiography ; Kidney Diseases/complications/radiography/*surgery ; Ligation ; Urethral Obstruction/complications/radiography ; Urinary Fistula/complications/radiography/*surgery ; Urinary Tract Infections/complications/radiography

Renal cell carcinoma associated with fused ectopic kidneys has rarely been reported in the literature. Here we report the first case of robot-assisted heminephrectomy for chromophobe renal cell carcinoma in an L-shaped fused ectopic kidney. The present case report highlights the importance of three-dimensional vision and enhanced maneuverability with the EndoWrist technology of the robotic surgical system for precise dissection. This report also highlights the importance of preoperative contrast-enhanced computed tomography with three-dimensional arterial reconstruction for surgical planning.
Carcinoma, Renal Cell/radiography/*surgery ; Female ; Humans ; Kidney/*abnormalities/radiography ; Kidney Neoplasms/radiography/*surgery ; Middle Aged ; Nephrectomy/*methods ; Robotic Surgical Procedures/*methods ; Tomography, X-Ray Computed

OBJECTIVE: Multilocular cystic renal cell carcinoma (MCRCC) is a recently described variety of renal cell carcinoma with characteristic pathologic and clinical features. The purpose of this study was to analyze the imaging findings of MCRCCs. MATERIALS AND METHODS: Ten adult patients with pathologically proven unilateral MCRCC who underwent renal US and CT were included in this study. The radiologic findings were retrospectively evaluated for cystic content, wall, septum, nodularity, calcification and solid portion by three radiologists who established a consensus. Imaging and postnephrectomy pathologic findings were compared. RESULTS: All patients were adults (six males and four females) and their ages ranged from 33 to 68 years (mean, 46). On US and CT images, all tumors appeared as well-defined multilocular cystic masses composed of serous or complicated fluid. In all patients, unenhanced CT scans revealed hypodense cystic portions, and in four tumors, due to the presence of hemorrhage or gelatinous fluid, some hyperdense areas were also noted. In no tumor was an expansile solid nodule seen in the thin septa, and in only one was there dystrophic calcification in a septum. Small areas of solid portion constituting less than 10% of the entire lesion were found in six of the ten tumors, and these areas were slightly enhanced on enhanced CT scans. In all patients, imaging and pathologic findings correlated closely. CONCLUSION: On US and CT images, MCRCC appeared as a well-defined multilocular cystic mass with serous, proteinaceous or hemorrhagic fluid, with no expansile solid nodules in the thin septa, and sometimes with small slightly enhanced solid areas. Where radiologic examinations demonstrate a cystic renal mass of this kind in adult males, MCRCC should be included in the differential diagnosis.
Carcinoma, Renal Cell/*radiography/*ultrasonography ; Female ; Human ; Kidney Neoplasms/*radiography/*ultrasonography ; Kidney, Cystic/radiography/ultrasonography ; Male ; Middle Age ; *Tomography, X-Ray Computed