Vascular renal anatomy and the ureteropelvic junction: preoperative multidetector CT scanning with split-bolus injection as a predictor of laparoscopic findings.
OBJECTIVE
To compare multidetector CT scan (MDCT) results with intraoperative findings in the detection of an inferior-pole pedicle crossing the ureteropelvic junction.


METHODS
Over the 2-year study period, 35 patients receiving laparoscopic pyeloplasty underwent preoperative investigation with a novel MDCT protocol in order to detect crossing vessels. Postprocessing, including maximum intensity projection, volume-rendering technique, and multiplanar reconstruction, was used in addition to standard axial views.


RESULTS
All the arteries found during laparoscopic surgery were detected by MDCT, but one radiologic false-positive was noted at the beginning of the series. Seven veins were not detected with MDCT. In the only case featuring an isolated inferior-pole vein, the aberrant vessel was identified by MDCT.


CONCLUSIONS
Multidetector CT scanning is a highly accurate way of providing all the information necessary preoperatively concerning renal parenchymal anomalies, urinary stones, and collecting system and vessel anatomy. It helps physicians make appropriate therapeutic decisions and gives surgeons information about what they can expect during laparoscopic procedures.
Sauer
Benoit
B
Service d'Imagerie Guilloz, Hôpital Central, Avenue de Lattre de Tassigny, CHU Nancy, France. benoit.sauer@neuf.fr
Flocquet
Muriel
M
Batch
Toufik
T
Blum
Alain
A
Hubert
Jacques
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage*; D006801:Humans; D007682:Kidney Pelvis / Q000000981:diagnostic imaging*; D010535:Laparoscopy; D008875:Middle Aged; D012077:Renal Artery / Q000000981:diagnostic imaging*; D012082:Renal Veins / Q000000981:diagnostic imaging*; D012371:Robotics; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014283:Triiodobenzoic Acids / Q000008:administration & dosage*; D014513:Ureter / Q000000981:diagnostic imaging*; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging* / Q000601:surgery
D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol