Comparison of contrast-enhanced color Doppler imaging (CDI), computed tomography (CT), and magnetic resonance imaging (MRI) for the detection of crossing vessels in patients with ureteropelvic junction obstruction (UPJO).
OBJECTIVE
To assess the use of contrast-enhanced color Doppler imaging (CDI), computed tomography (CT), and magnetic resonance imaging (MRI) for the detection of crossing vessels at the ureteropelvic junction (UPJ) in patients with ureteropelvic junction obstruction (UPJO).


METHODS
Forty-eight patients aged 18-69 yr (mean age, 52) who had been diagnosed with an UPJO on intravenous pyelography and diuretic renography were included. Contrast-enhanced CDI was performed by using both color Doppler frequency and color Doppler amplitude ("Power") modes. Spiral CT was performed by using a three-phase CT (arterial, venous, and excretory phases) allowing for CT angiography. MRI technique included dual-phase magnetic resonance angiography (arterial, venous) for the assessment of respective arteries and veins. The type (ie, arterial or venous) and position of the vessel relative to the UPJ (ie, anterior or posterior) were assessed. The CDI, CT, and MRI findings were correlated with the surgical findings at laparoscopic pyeloplasty.


RESULTS
Forty-four of 48 patients (92%) demonstrated crossing vessels at subsequent laparoscopy. Altogether a total of 60 vessels were detected. Contrast-enhanced CDI and MRI correctly detected all crossing vessels (accuracy, 100%), whereas CT missed four posterior crossing veins (accuracy, 93%).


CONCLUSIONS
Contrast-enhanced CDI is recommended as first-line imaging modality for the detection of crossing vessels in patients with UPJO.
Department of Urology, Medical University Innsbruck, Innsbruck, Austria. michael.mitterberger@uibk.ac.at <michael.mitterberger@uibk.ac.at>
Michael
M
Mitterberger
Germar M
GM
Pinggera
Richard
R
Neururer
Reinhard
R
Peschel
Daniela
D
Colleselli
Friedrich
F
Aigner
Johann
J
Gradl
Georg
G
Bartsch
Hannes
H
Strasser
Leo
L
Pallwein
Ferdinand
F
Frauscher
D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D006801:Humans; D007682:Kidney Pelvis / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D014517:Ureteral Obstruction / Q000175:diagnosis*
D003287:Contrast Media