Duplicated Ectopic Ureter with Vaginal Insertion: 3D CT Urography with IV and Percutaneous Contrast Administration

Abstract

WEB This is a Web exclusive article. uplication of the ureters is a common congenital anomaly frequently encountered in children. Complete duplication is most often associated with vesicoureteral reflux, ectopic ureterocele, and ectopic ureteral insertion. Because of poor function and anatomic variations, these anomalies are sometimes difficult to detect on excretory urography, sonography, and voiding cystourethrography (VCUG). Visualization of the course of duplicated ectopic ureters and the insertion of the ureters is of utmost importance for treatment and surgical planning. We present the case of a woman with duplicated ectopic ureter with vaginal insertion. Excretory urography, sonography, and VCUG had failed in visualization of the anatomic course and insertion of the nonfunctioning ectopic ureter. Percutaneous injection of iodinated contrast medium into the dilated collecting system and IV contrast administration was performed during CT examination of the abdomen and pelvis. Postprocessing that included volume-rendered and maximum-intensity-projection reformatted 3D images clearly showed the entire ectopic ureter in various planes. In addition to data about the exact location of the extravesical drainage of the ureter, the study provided information about the anatomic relations between the two ureters and their tortuous intimate course.