Anatomy of ureterovesical junction and distal ureter studied by endoluminal ultrasonography in vitro.
OBJECTIVE
The emerging technique of endoluminal ultrasonography (ELUS) provides a new modality for endoscopic visualization of the urinary tract which needs to be further evaluated. We studied the normal anatomy of distal ureter and ureterovesical junction using ELUS.


METHODS
An assessment of in vitro ELUS ureteric images undertaken at 1 mm. intervals from 8 fresh human cadaver pelvis blocs of bladder and distal ureter were compared with findings of serial histological sections of the same specimens (stained for cholinesterase isoenzymes) to assess the degree of correlation. Computer-assisted 3D reconstructions were made.


RESULTS
The different components (ureteric, detrusor and periureteric tissue) of the UVJ could be identified on the basis of echogenicity and form, but differentiation between the respective muscle layers in the wall of the ureter or of the detrusor was not possible. Nevertheless, ureteric volume measurements and an assessment of transmural ureteric length and the angle of passage through the bladder wall were possible.


CONCLUSIONS
ELUS is able to differentiate between the ureteric and detrusor muscle and the UVJ gross anatomy can be reconstructed. ELUS technology, however, fails to differentiate between individual muscular layers of the ureter or the detrusor. Further improvement in ELUS is mandatory.
Roshani
H
H
Department of Urology, University of Amsterdam, Academic Medical Center Amsterdam, The Netherlands.
Dabhoiwala
N F
NF
Verbeek
F J
FJ
Kurth
K H
KH
Lamers
W H
WH
D006801:Humans; D066298:In Vitro Techniques; D014463:Ultrasonography / Q000379:methods; D014513:Ureter / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D001743:Urinary Bladder / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*