[Multislice CT arteriography in the pre-surgical evaluation of patients with ureteropelvic junction stenosis].
BACKGROUND
The current treatment of choice for ureteropelvic stenosis is endopyelotomy, but the presence of vessels in contact with the stenotic area of the ureteropelvic junction reduces the success of these interventions and increases vascular and hemorrhagic complications. The aim of our study was to use multislice CT arteriography to evaluate patients prior to surgery for ureteropelvic junction stenosis.


METHODS
16 patients with ureteropelvic junction stenosis underwent multislice CT arteriography; multidirectional images and three-dimensional reconstructions were used to identify and characterize vessels in contact with the stenotic area of the ureteropelvic junction.


RESULTS
A total of eight vessels (four arteries and four veins) in six (38%) patients were found in contact with or passing within 2 mm of the ureteropelvic junction. The vessels were located anterior to the junction in four cases; it was posterior in one case, and anteromedial in the other. Endopyelotomy was contraindicated in the six patients in whom vessels were found in contact with the ureteropelvic junction. The presence of the vessels was confirmed during surgery in five of these patients; the remaining patient did not undergo surgery).


CONCLUSIONS
Multislice CT arteriography allows adequate presurgical evaluation of ureteropelvic junction stenosis, detecting the presence of crossing vessels and facilitating the planning of the surgical approach in these patients.
Braun
P
P
Servicio de Radiodiagnóstico de Adultos, Hospital Universitario La Fe, Valencia, España. PetraBraun@gmx.de
Pamies Guilabert
J
J
Bou Alapont
M J
MJ
D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods; D005260:Female; D006801:Humans; D007682:Kidney Pelvis; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D014057:Tomography, X-Ray Computed / Q000379:methods; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging* / Q000601:surgery*