BACKGROUND: Crossing renal vessels (CRV) are associated with ureteropelvic junction (UPJ) obstruction, particularly when presentation is beyond the neonatal period. Their presence may influence surgical management. OBJECTIVE: To evaluate the accuracy of contrast-enhanced magnetic resonance angiography (CE-MRA) in the identification of CRV in children requiring surgical treatment of symptomatic UPJ obstruction, against a gold standard of laparoscopic or open surgical findings. MATERIALS AND METHODS: We reviewed CE-MRA studies (3-D T2-weighted turbo spin-echo and multiphase 3-D spoiled gradient echo following intravenous gadolinium administration) of 14 children, age range 6-15 years, performed prior to surgery for suspected CRV-related UPJ obstruction. Consensus reviews of the CE-MRA studies were compared with surgical findings. RESULTS: CE-MRA demonstrated CRV at the level of the obstruction in nine and no crossing vessels in five children. These were all verified intraoperatively (chi2=14.0; P<0.001). In eight of the nine patients with CRV there was no evidence of intrinsic obstruction at surgery. In the remaining patient there was fibrosis of the upper ureter. CONCLUSION: CE-MRA is an accurate means of identifying CRV in children older than 6 years with symptomatic UPJ obstruction.
BACKGROUND: Crossing renal vessels (CRV) are associated with ureteropelvic junction (UPJ) obstruction, particularly when presentation is beyond the neonatal period. Their presence may influence surgical management. OBJECTIVE: To evaluate the accuracy of contrast-enhanced magnetic resonance angiography (CE-MRA) in the identification of CRV in children requiring surgical treatment of symptomatic UPJ obstruction, against a gold standard of laparoscopic or open surgical findings. MATERIALS AND METHODS: We reviewed CE-MRA studies (3-D T2-weighted turbo spin-echo and multiphase 3-D spoiled gradient echo following intravenous gadolinium administration) of 14 children, age range 6-15 years, performed prior to surgery for suspected CRV-related UPJ obstruction. Consensus reviews of the CE-MRA studies were compared with surgical findings. RESULTS: CE-MRA demonstrated CRV at the level of the obstruction in nine and no crossing vessels in five children. These were all verified intraoperatively (chi2=14.0; P<0.001). In eight of the nine patients with CRV there was no evidence of intrinsic obstruction at surgery. In the remaining patient there was fibrosis of the upper ureter. CONCLUSION: CE-MRA is an accurate means of identifying CRV in children older than 6 years with symptomatic UPJ obstruction.
Authors: Benjamin B McDaniel; Richard A Jones; Hal Scherz; Andrew J Kirsch; Stephen B Little; J Damien Grattan-Smith Journal: AJR Am J Roentgenol Date: 2005-12 Impact factor: 3.959
Authors: Ahmed R El-Nahas; Mohamed Abou-El-Ghar; Ahmed M Shoma; Ibrahim Eraky; Mahmoud R El-Kenawy; Hamdy El-Kappany Journal: BJU Int Date: 2004-09 Impact factor: 5.588
Authors: Nicolas Brucher; Julie Vial; Christiane Baunin; David Labarre; Olivier Meyrignac; Michel Juricic; Ourdia Bouali; Olivier Abbo; Philippe Galinier; Nicolas Sans Journal: Eur Radiol Date: 2015-10-29 Impact factor: 5.315