OBJECTIVETo observe the imaging findings of congenital megaureter in order to enhance the understanding of this disease.

METHODSImage data of 5 patients with congenital megaureter and 2 misdiagnosed patients were analyzed, and image findings of congenital megaureter were summarized.Elscint Prestig 2.0T superconductive magnetic resonance urography (MRU) with conventional sequence (spin-echo, T1WI560 ms/16 ms; fast spin-echo, T2WI 9600 ms/96 ms ) was performed. Raw data were acquired with fastspin-echo sequence from heavy T2-weighted image (9600 ms/120 ms). Post-processing method of MRU was the maximum intensity projection with three-dimensional reconstruction in the workstation. Intravenous pyelography (IVP) was conducted, in which X-rayfilms were taken 7 minutes, 15 minutes, and 30 minutes after injecting contrast agent, exceptthat in 2 patients the films were taken delayed at 60 and 90 minutes .X-ray retrograde pyelography was performed on 2 patients, successful in one butfailed in the other.

RESULTSThe dilated ureter showed hypointensity on T1-weighted images and hyperintensity on T2-weighted images in conventional MRI. The mass wall was intact, uniform in thickness, and showing hypointensity on T1-weighted and T2-weighted images. The MRU images showed a retroperitoneal mass appearing as an elongated tubular cystic structure spreading from kidney to bladder. MRU also revealed dilated calices and renal pelvis, pelviureteric obstruction, and renal duplication. The main signs of congenital megaureter in X-urography was significant dilatation of ureter, or normal renal pelvis with ureter dilatation, hydronephrosis, deformity, and displacement.

CONCLUSIONSMRU with X-urography could visualizethe characteristics of congenital megaureter, including the dilation of renal pelvis and ureter, calculi, urinary tract duplication, and stenosis location. The two techniques can complement each other in disease diagnosis and provide more detailed information for preoperative treatment.

Humans ; Magnetic Resonance Imaging ; methods ; Ureter ; abnormalities ; pathology ; Urography

OBJECTIVETo evaluate magnetic resonance urography (MRU) in the diagnosis of urinary tract obstruction after renal transplantation.

METHODSA total of 31 patients with suspected urinary tract obstruction after renal transplantation were examined, and the results were compared with those from surgery and B-ultrasound examination.

RESULTSThe urinary tract after renal transplantation was clearly shown using MRU, and all patients were clearly diagnosed by MRU. Imaging results were consistent with those from surgery.

CONCLUSIONSMRU is suitable for detecting urinary tract obstruction after renal transplantation. It is a alternative method for IVP and CT in patients with renal function impairment and uremia.

Humans ; Kidney Transplantation ; Magnetic Resonance Imaging ; methods ; Ureteral Obstruction ; diagnosis ; Urinary Tract ; pathology ; Urography ; methods

OBJECTIVE: To explore the diagnostic value of magnetic resonance urography (MRU) in ectopic ureters. METHODS: Seventeen female children with ectopic ureter were examined by sonography, intravenous urography (IVU), computer tomography (CT), MRU and so on. The mean age of the female children was 4.5 years (7 months approximately 12 years). RESULTS: Seventeen patients were examined by sonography, including 3 dysplasia little kidneys, 1 kidney absence, 12 duplex kidneys with hydroureter, 1 normal.Seven patients were examined by IVV, including 3 hydronephrosis and 4 no image or not clear. Fourteen patients were examined by CT, including 3 dysplasia little kidneys, 11 duplex kidneys with hydronephrosis. Five were determined by cystoscope, including 2 ecto-pic urethral orifices which angiography could only display the expansion of ureter. All children were diagnosed by MRU and an accurate anatomical picture of the entire urinary tract was obtained. CONCLUSION To accurately and noninvasively depict the urinary tract and the independence of renal function, MRU may be used for patients with ectopic ureter undiagnosed with sonography and IVU.
Child ; Child, Preschool ; Female ; Humans ; Infant ; Magnetic Resonance Imaging ; methods ; Ureter ; abnormalities ; Urography ; methods

The determination of the degree and ability of recovery of obstructive hydronephrosis is important in treatment and prediction of prognosis. Among the various methods in determination of the status of kidney, intravenous pyelography is the most important tool to evaluate the morphological and functional changes of kidney in vivo. The purpose of this experiment was the determination of process and recoverability of hydronephrosis depend on duration of unilateral uretreal obstruction. For the experiment, 32 rats were divided into 2 groups; the first group of 12 rats were used to determine the process of hydronephrosis during 1 to 4 weeks of unilateralureteral ligation and the second group of 20 rats were used to determine the recoverability of hydronephrotic kidney depend on same duration of ureteral ligation following relief of ligation. Intravenous pyelography as undertaken and renal angiography, gross and microscopic examination were added. The results obtained are summarized as follows; 1. Kidney enlargement and pelvic dilatation were progressively increased with a relation to duration of ureteral obstruction until 4 weeks. 2. Renal excretory function is not impaired until 3 weeks obstruction, but rapidly impaired to nonfunctioning in 4 weeks obstruction. 3. Renal recovery was possible following relief of ureteral ligation within 3 weeks of ureteral obstruction, but histopathological and functional recovery were impossible in 4 weeks of ureteral ligation. 4. There is no direct correlation between duration of obstruction and recoverability following relief within 3 weeks of uretral obstruction. 5. Intravenous pyelographyis a simple and accurate method to determine the degree of obstructive hydronephrosis and to evaluate morphological and functional recovery of kidney following relief of obstruction.
Angiography ; Animals ; Dilatation ; Hydronephrosis ; Kidney ; Ligation ; Methods ; Prognosis ; Rats ; Ureter ; Ureteral Obstruction ; Urography

Clinical and radiological observation was made on the 42 cases of childhood hydronephrosis patients admittedto Hanyang University Hospital from June, 1972 to August, 1982. Performed diagnsotic methods were exccretoryurography, retrograde pyelography, voiding cystourethrography and other advanced form of radiological methods suchas angiography or ultrasonography. The resultls were as follows; 1. The male patient were more frequent thanfemale patient and its ratio was 29:13. 2. 18 out of 42 patients were below 5 years of age and 9 of them were lessthan 1 year old. 3. Abdominal mass was the common presenting feature especially on obstructive hydronephrosis.Genitourinary symptoms or flank pain was the most frequent compliant in older children. Nongenitourinary symptomswere also noted especially in nonobstructive hydronephrosis of young children. 4. Obstructive hydronephrosis were26 cases and nonobstructive hydronephrosis were 17 cases. Pelviureteric junction was most frequent obstructionsite and intrinsic stricture was more frequent than extrinsic lesion. Vesicoureteric reflux and recurrent urinarytract infection was the frequent causes of nonobstructive hydronephrosis. 5. Both kidneys are equally affedted inall of cases. The left side was more frequently affected in obstructive hydronephrosis cases. 6. Voidingcystourethrography was performed in 14 cases and showed V-U reflux in 8 cases especially of mild nonobstructivehydronephrosis. 7. Ultrasonography was performed in 10 cases and it was the good method for diagnosis especiallywhen the abdominal mass was the presenting feature in children. 8. Most of operated cases were severe, grade IIIor IV, obstructive hydronephrosis cases. 9. Associated abnormalities affecting the genitourinary tract was foundin 17 cases. Nongenitourinary tract abnormalities were present in 20 cases especially associated with spinalanomaly.
Angiography ; Child ; Constriction, Pathologic ; Diagnosis ; Flank Pain ; Humans ; Hydronephrosis ; Kidney ; Male ; Methods ; Ultrasonography ; Urography

The authors performed percutaneous antegrade pyelography guided by ultrasound on 33 patients, from J une 1982 to October 1984, at the department of radiology, Busan National University Hospital. The results obtained were as follows: 1. Of the 31 cases,17 cases (5 1.5%) were female and 16 cases (48.5 %)were male,and age distribution was nearly even, but most prevalent age group was third decade. 2. Comparing intravenous pyelographic findings with ultrasonographic findings, pyelographically non. visualized kidney 15 cases (45 .5%) were hydronephrosis 12 cases, multiple cysts 2 cases, and intrarenal cystic mass 1 case, ultrasonographically. Pyelographically hydronephrosis 9 cases (27.3%) were all hydronephrosis, ultrasonographically. Intrarenal mass 5 cases (15.2%) were all intrarenal cystic mass, NVK with air in kidney 1 case (3.0%) was air in perirenal space, partial NVK 1 case (3.0%) was per. irenal fluid , suprarenal mass 1 case (3 .0%) was suprarenal intrarenal and huge perirenal cystic masses, ultraso nograp h ically. 3. On technical reliability of antegrade pyelography under ultrasound gUide, 31 cases (93 .9%) could be done fluid aspiration and visualization, and 2 cases (6.1 %) could be only done fluid aspiration but failed visualization . 31 successful cases were visualization of collecting systems 23 cases, visualization of cyst 6 cases, i!nd visualization of perirenal space 2 cases. 2 partial successful cases were perirenal injection 1 case and parenchymal injection 1 case. 4. On fluid aspiration, 22 cases (66.7%) were clear, but 11 cases (33.3%) were not clear, which were pus 7 cases, turbid urine 2 cases, bloody urine 1 case, and bloody pus and air 1 case. 5. Comparing ultrasonographic findings with antegrade pyelographic findings, ultrasonographically hydronephrosis 21 cases revealed obstruction in 16 cases, antegrade pyelographically, which were consisted of ureteral stricture 14 cases, ureteral stone 1 case, and ureteral mass 1 case, non-obstruction in 4 cases, which were consisted of pyonephrosis 2 cases, posterior urethral valve 1 case, and megaureter 1 case, and other 1 case was visualization failure. Ultrasonographically intrarenal cystic mass 6 cases were simple renal cyst 4 cases, and infected renal cyst 2 cases, antegrade pyelographically. Multiple cysts 2 cases were lobulated huge renal cyst 1 case, and visualization failure 1 case, which was multi.cystic kidney. Air in perirenal space 1 case was emphysematous pyelone. phritis, suprarenal cystic mass 1 case was complete duplication with ectopic ureteral orifice, perirenal fluid 1 case due to kidney fracture was perirenal fluid , and intrarenal and perirenal cystic mass was per irenal abscess, antegrade pyelographically. 6. On ana lysis of anteg rade pyelography result as next diagnostic step of ultrasound, 31 successful cases were 27 conclusive diagnostic cases (87.1%), and 4 heplful diagnostic cases (12.9%) with percutaneous antegrade pyelography guided by ultrasound . 7. Antegrade pyelography provides significant diagnostic information on the nature of the obstructive lesion and can be performed as an adjunct to retrograde study or as an alterative to a pyelogram. 8. Ultrasonographic examination could be performed easiJy in diagnosis of renal and perirenal diseases as non.invasive method without risk of radiation hazard , and was not influenced by renal function. 9. Ultrasound is considered a most advantageous aid to the performance of antegrade pyelography and has yie lded valuab le diagnostic information in patients with obstructive hydronephrosis.
Abscess ; Age Distribution ; Busan ; Constriction, Pathologic ; Diagnosis ; Female ; Humans ; Hydronephrosis ; Kidney ; Methods ; Pyonephrosis ; Suppuration ; Ultrasonography ; United Nations ; Ureter ; Urography

This review article comprehensively discusses multidetector CT urography protocols and their role in imaging of the urinary tract in patients with hematuria.
Hematuria/etiology/*radiography ; Human ; Incidental Findings ; Sensitivity and Specificity ; Tomography, X-Ray Computed/*methods/standards ; Urinary Tract/abnormalities ; Urography/methods/standards ; Urologic Diseases/complications/congenital/radiography

OBJECTIVETo retrospectively evaluate the clinical feasibility of high-pitch excretory phase images during dual-source CT urography with Stellar photon detector.

METHODSTotally 100 patients received dual-source CT high-pitch urinary excretory phase scanning with Stellar photon detector [80 kV, ref.92 mAs, CARE Dose 4D and CARE kV, pitch of 3.0, filter back projection reconstruction algorithm (FBP)] (group A). Another 100 patients received dual-source CT high-pitch urinary excretory phase scanning with common detector(100 kV, ref.140 mAs, CARE Dose 4D, pitch of 3.0, FBP) (group B). Quantitative measurement of CT value of urinary segments (Hounsfield units), image noise (Hounsfield units), and effective radiation dose (millisievert) were compared using independent-samples t test between two groups. Urinary system subjective opacification scores were compared using Mann-Whitney U test between two groups.

RESULTSThere was no significant difference in subjective opacification score of intrarenal collecting system and ureters between two groups (all P>0.05). The group A images yielded significantly higher CT values of all urinary segments (all P<0.01). There was no significant difference in image noise (P>0.05). The effective radiation dose of group A (1.1 mSv) was significantly lower than that of group B (3.79 mSv) (P<0.01).

CONCLUSIONHigh-pitch low-tube-voltage during excretory phase dual-source CT urography with Stellar photon detector is feasible, with acceptable image noise and lower radiation dose.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Image Processing, Computer-Assisted ; Male ; Middle Aged ; Retrospective Studies ; Tomography, Spiral Computed ; methods ; Urography ; methods ; Young Adult

OBJECTIVE: To compare the usefulness of unenhanced spiral CT (UCT) with that of excretory urography (EU) in patients with acute flank pain. MATERIALS AND METHODS: Thirty patients presenting with acute flank pain under-went both UCT and EU. Both techniques were used to determine the presence, size, and location of urinary stone, and the presence or absence of secondary signs was also evaluated. The existence of ureteral stone was confirmed by its removal or spontaneous passage during follow-up. The absence of a stone was determined on the basis of the clinical and radiological evidence. RESULTS: Twenty-one of the 30 patients had one or more ureteral stones and nine had no stone. CT depicted 22 of 23 calculi in the 21 patients with a stone, and no calculus in all nine without a stone. The sensitivity and specificity of UCT were 96% and 100%, respectively. EU disclosed 14 calculi in the 21 patients with a stone and no calculus in eight of the nine without a stone. UCT and EU demon-strated secondary signs of ureterolithiasis in 15 and 17 patients, respectively. CONCLUSION: For the evaluation of patients with acute flank pain, UCT is an excellent modality with high sensitivity and specificity. In near future it may replace EU.
Adult ; Colic/*radiography ; Female ; Human ; Male ; Middle Age ; Sensitivity and Specificity ; Tomography, X-Ray Computed/*methods ; Ureteral Calculi/*radiography ; Ureteral Diseases/*radiography ; *Urography

Adult ; Humans ; Male ; Neoplasms, Fibroepithelial ; diagnostic imaging ; Polyps ; diagnostic imaging ; Radionuclide Imaging ; Technetium Tc 99m Mertiatide ; Ureteral Neoplasms ; diagnostic imaging ; Urography ; methods