DOI: 10.1148/rg.251045510
RadioGraphics 2005;25:121-134
© RSNA, 2005
Adult Ureteropelvic Junction Obstruction: Insights with Three-dimensional Multi–Detector Row CT1
Leo P. Lawler, MD, FRCR,
Thomas W. Jarret, MD,
Frank M. Corl, MS and
Elliot K. Fishman, MD
1 From the Russell H. Morgan Department of Radiology and Radiological Science (L.P.L., F.M.C., E.K.F.) and the James Buchanan Urological Institute (T.W.J.), the Johns Hopkins Medical Institutions, 601 N Caroline St, Rm 3254, Baltimore, MD 21287-0801. Presented as an education exhibit at the 2003 RSNA Scientific Assembly. Received February 23, 2004; revision requested April 14 and received June 23; accepted July 28. All authors have no financial relationships to disclose. Address correspondence to L.P.L. (e-mail: llawler@jhmi.edu).
Ureteropelvic junction obstruction (UPJO) is a benign, congenital condition that remains an enigma in terms of both diagnosis and therapy. On the basis of a series of cases that were referred to the authors in their clinical practice, they found that the unprecedented quality and novel perspectives of multi–detector row computed tomography (CT) with two- and three-dimensional postprocessing allow a comprehensive, single-study assessment of the ureterovascular relationships in UPJO. This topic is important because the causative role of crossing vessels may be questioned on the basis of such studies, and the therapeutic approach may be altered by using precise anatomic images customized to the pathologic features of the individual patient. Although CT images can provide only circumstantial or supportive evidence of the pathophysiology of UPJO, they greatly facilitate therapeutic intervention when it is clinically indicated and may eliminate the need for it in select cases. Careful attention to the postprocessing of CT images may show that the crossing vasculature has no direct relationship to the transition point of the UPJO in many cases.
© RSNA, 2005
Copyright © 2005 by the Radiological Society of North America.
