title: Kidney fusion anomalies revisited: clinical and radiological analysis of 209 cases of crossed fused ectopia and horseshoe kidney.
abstract: OBJECTIVE
  To analyse the morphological appearance of horseshoe kidneys (HKs) and crossed fused ectopia (CFE) and to assess the frequency and clinical significance of associated anomalies and diseases.
  
  
  METHODS
  The findings and images of 209 patients with fused kidneys (FKs) were reviewed; in all, 244 scans from computed tomography (CT), 233 ultrasonograms and 89 micturition cysto-urethrograms, urograms, magnetic resonance images and angiograms were taken.
  
  
  RESULTS
  HKs (found in one of 474 abdominal CT scans) and CFEs (found in one of 3078 CT scans) showed a high variability of vasculature that could not be classified. However, some generalized conclusions were possible about the renal vasculature (430 arteries in 103 kidneys). Variants of the most cephalad artery of both sides were rare. The second artery on the right had a pre-caval course. The origins of vessels located further caudal were more ventral. CFEs were anatomically different from HKs with respect to lower position, greater axial rotation, smaller pelvic width, more caudal origin, and fewer vessels, but not in accompanying anomalies. Severe anomalies or malformations were found in 23% of patients, with half of them in the urogenital system. Malformations were found considerably more often in children than in adults. There was no increased incidence of diseases such as stones or inflammation of the renal pelvis.
  
  
  CONCLUSIONS
  Concomitant anomalies and diseases were equally frequent for HK and CFE, but less frequent than generally assumed. Individual cases of complex anatomical situations require special examination strategies, and CT appears to be the most reliable imaging method.
authors: Department of Radiology, Innsbruck Medical University, Innsbruck, Austria. bernhard.glodny@i-med.ac.at
authors: Bernhard
authors: B
authors: Glodny
authors: Johannes
authors: J
authors: Petersen
authors: Karin J
authors: KJ
authors: Hofmann
authors: Claudia
authors: C
authors: Schenk
authors: Ralf
authors: R
authors: Herwig
authors: Thomas
authors: T
authors: Trieb
authors: Christian
authors: C
authors: Koppelstaetter
authors: Iris
authors: I
authors: Steingruber
authors: Peter
authors: P
authors: Rehder
mesh_terms: D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities* / Q000098:blood supply; D007674:Kidney Diseases / Q000175:diagnosis / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed