Abstract
BackgroundDuplex kidney is a common anomaly that is frequently associated with multiple complications. Typical computed tomography urography (CTU) includes four phases (unenhanced, arterial, parenchymal and excretory) and has been suggested to considerably aid in the duplex kidney diagnosi. Unfortunately, regarding duplex kidney with prolonged dilatation, the affected parenchyma and tortuous ureters demonstrate a lack of or delayed excretory opacification. We used prolonged-delay CTU, which consists of another prolonged-delay phase (1- to 72-h delay; mean delay: 24 h) to opacify the duplicated ureters and affected parenchyma.MethodsSeventeen patients (9 males and 8 females; age range: 2.5–56 y; mean age: 40.4 y) with duplex kidney were included in this study. Unenhanced scans did not find typical characteristics of duplex kidney, except for irregular perirenal morphology. Duplex kidney could not be confirmed on typical four-phase CTU, whereas it could be easily diagnosed in axial and CT-3D reconstruction using prolonged CTU (prolonged-delay phase).ResultsBetween January 2005 and October 2010, in this review board-approved study (with waived informed consent), 17 patients (9 males and 8 females; age range: 2.5 ~ 56 y; mean age: 40.4 y) with suspicious duplex kidney underwent prolonged CTU to opacify the duplicated ureters and confirm the diagnosis.ConclusionOur results suggest the validity of prolonged CTU to aid in the evaluation of the function of the affected parenchyma and in the demonstration of urinary tract malformations.
Highlights
Duplex kidney is a common anomaly that is frequently associated with multiple complications
Duplex kidney could not be confirmed on typical four-phase computed tomography urography (CTU), whereas duplex kidney was diagnosed in axial and 3D reconstruction on prolonged-delay CTU
Renal function of duplex kidney could be well assessed in prolonged-delay CTU (Figs. 1-5)
Summary
Duplex kidney is a common anomaly that is frequently associated with multiple complications. Despite being detected on excretory urography, ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI), the affected parenchymal function and anatomic variations of duplex kidney are frequently difficult to assess using these imaging modalities [2]. Assessment of the affected parenchymal function and visualization of the entire duplicated ureters/collecting systems are important for surgical planning and long-term follow-up. The resultant 3D images clearly showed the entire ectopic ureter in various planes. This method is very useful when evaluating duplicated ureter-related abnormities. This method cannot reveal the function of the affected duplex kidney, and the method is invasive
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