2190 THE NATURE OF CROSSING VESSELS IN PATIENTS WITH RADIOGRAPHICALLY NORMAL URETEROPELVIC JUNCTIONS: INCIDENCE AND ANATOMIC CHARACTERISTICS

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology II1 Apr 20122190 THE NATURE OF CROSSING VESSELS IN PATIENTS WITH RADIOGRAPHICALLY NORMAL URETEROPELVIC JUNCTIONS: INCIDENCE AND ANATOMIC CHARACTERISTICS David Leavitt, Adam Nicholson, Omar Ortiz-Alvarado, Thomas Maust, Geoffrey Rutledge, Sidney Walker, and James Kyle Anderson David LeavittDavid Leavitt Minneapolis, MN More articles by this author , Adam NicholsonAdam Nicholson Minneapolis, MN More articles by this author , Omar Ortiz-AlvaradoOmar Ortiz-Alvarado Minneapolis, MN More articles by this author , Thomas MaustThomas Maust Minneapolis, MN More articles by this author , Geoffrey RutledgeGeoffrey Rutledge Minneapolis, MN More articles by this author , Sidney WalkerSidney Walker Minneapolis, MN More articles by this author , and James Kyle AndersonJames Kyle Anderson Minneapolis, MN More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2364AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Previous series have described the incidence of crossing vessels in the setting of ureteropelvic junction obstruction between 39% and 71%, but to our knowledge this is the first study to evaluate the incidence and characteristics of crossing vessels in patients with radiographically normal and unobstructed ureteropelvic junctions. METHODS We retrospectively reviewed the computed tomography angiography images of 601 patients who were evaluated for possible organ donation at the University of Minnesota between 2005 and 2008. One patient had an asymptomatic ureteropelvic junction obstruction and was excluded from the analysis. The incidence and characteristics of crossing vessels at the ureteropelvic junction were determined including vessel location, origin, size, distance from the ureteropelvic junction and vessel type (artery or vein). To serve as a quality control of our image review, the images of 120 patients (20%) were independently reviewed by a University of Minnesota radiologist with fellowship training in cross-sectional body imaging. RESULTS The incidence of crossing vessels at the radiographically normal ureteropelvic junction was 22.8%. A total of 164 crossing vessels were present in 137 patients, and 60.4% were left-sided while 39.6% were right-sided. Arteries accounted for 80.5% of the crossing vessels and veins accounted for 19.5%. Lower pole renal vessels comprised 59.8% of the crossing vessels. The location of the crossing vessel relative to the ureteropelvic junction varied including anterior (25.6%), anterolateral (36.6%), medial (15.2%), anteromedial (2.5%), lateral (12.8%) and posterior (7.3%). The mean diameter and mean distance of the crossing vessels from the ureteropelvic junction was 3.3 mm and 1.8 mm, respectively. There was 100% concordance in image interpretation between the urologists and the radiologist. CONCLUSIONS The incidence of crossing vessels in kidneys with radiographically normal ureteropelvic junctions was 22.8%, which is lower than that seen in association with ureteropelvic junction obstruction. The location of crossing vessels was variable and no location was consistently free from traversing vessels. There was good agreement between urologist and radiologist in describing the incidence and nature of crossing vessels on computed tomography angiography. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e883 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Leavitt Minneapolis, MN More articles by this author Adam Nicholson Minneapolis, MN More articles by this author Omar Ortiz-Alvarado Minneapolis, MN More articles by this author Thomas Maust Minneapolis, MN More articles by this author Geoffrey Rutledge Minneapolis, MN More articles by this author Sidney Walker Minneapolis, MN More articles by this author James Kyle Anderson Minneapolis, MN More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...