Endoscopie virtuelle en tomodensitométrie des voies urinaires supérieures Études expérimentales in vitro et in vivo

Abstract

Summary We report our preliminary experience in virtual endoscopy (VE) of the upper urinary tract (UUT) in an experimental model, a cadaver kidney and three patients with renal cavities filling defects (stones and tumor). The experimental model consists of a water-filled surgical glove containing a 2 mm calculi, a piece of red meat and a blood clot. A 2 mm stone was inserted in the pyeloureteral junction of a cadaver kidney. Three patients, one with a stone and an infiltrating tumor of the lower calices and two with a caliceal stone, were scanned. Single helical scanning using 3 mm slice thickness and 1:1 or1:1.5 pitch was performed in all cases, with a reconstruction pitch of 1 mm or 0.5 mm. Specific software allowed us to differentiate and to color the different filling defects according to their own densities. VE could be achieved in all cases. Although VE permits spectacular images, this technique does not produce any new information apart from that available in the axial slices. VE allows rapid evaluation of the complex morphology of hollow organs in a more “anatomical” fashion. VE permits the endoscopic evaluation of organs not routinely evaluated by endoscopy, such as the UUT. Further studies are needed to evaluate the clinical pertinence of VE.