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Evaluation of Crossing Vessels in Patients with Ureteropelvic Junction Obstruction by Means of Helical CT¹

¹ From the Department of Radiology, Himeji Red Cross Hospital, 5-30-1 Tatsuno-cho, Himeji City, Hyogo 670-8540, Japan (A.M.); and the Departments of Radiology (K.Y., S.A., I.T., I.J., Y.H.) and Urology (H.H., H.K.), Okayama University Medical School, Japan. Presented as a scientific exhibit at the 1998 RSNA scientific assembly. Received January 27, 1999; revision requested May 11; final revision received December 10; accepted December 13. Address correspondence to A.M.

View larger version (105K): [in a new window]   Figure 1a.   Posterior crossing artery associated with UPJ obstruction in a 40-year-old woman. (a) Axial CT scans (left image obtained at a higher level than right image) show a dilated right renal pelvis (arrows) and a crossing vessel (arrowheads). (b) Axial CT scans show planes used for coronal (left image) and curved (right image) reconstruction. U = ureter. (c) Coronal image reconstructed along the straight line in b shows the small vessel (arrow) adjacent to the most stenotic point of the UPJ. Ao = aorta, Kd = kidney, Lt = left, RP = renal pelvis, Rt = right, U = ureter. (d) Curved image reconstructed along the course of the crossing vessel (curved line in b) shows the small vessel (arrows) branching from the aorta (Ao) and crossing the UPJ. Kd = kidney, Lt = left, RP = renal pelvis, RtPo = right posterior, U = ureter.

View larger version (105K): [in a new window]   Figure 1b.   Posterior crossing artery associated with UPJ obstruction in a 40-year-old woman. (a) Axial CT scans (left image obtained at a higher level than right image) show a dilated right renal pelvis (arrows) and a crossing vessel (arrowheads). (b) Axial CT scans show planes used for coronal (left image) and curved (right image) reconstruction. U = ureter. (c) Coronal image reconstructed along the straight line in b shows the small vessel (arrow) adjacent to the most stenotic point of the UPJ. Ao = aorta, Kd = kidney, Lt = left, RP = renal pelvis, Rt = right, U = ureter. (d) Curved image reconstructed along the course of the crossing vessel (curved line in b) shows the small vessel (arrows) branching from the aorta (Ao) and crossing the UPJ. Kd = kidney, Lt = left, RP = renal pelvis, RtPo = right posterior, U = ureter.

View larger version (108K): [in a new window]   Figure 1c.   Posterior crossing artery associated with UPJ obstruction in a 40-year-old woman. (a) Axial CT scans (left image obtained at a higher level than right image) show a dilated right renal pelvis (arrows) and a crossing vessel (arrowheads). (b) Axial CT scans show planes used for coronal (left image) and curved (right image) reconstruction. U = ureter. (c) Coronal image reconstructed along the straight line in b shows the small vessel (arrow) adjacent to the most stenotic point of the UPJ. Ao = aorta, Kd = kidney, Lt = left, RP = renal pelvis, Rt = right, U = ureter. (d) Curved image reconstructed along the course of the crossing vessel (curved line in b) shows the small vessel (arrows) branching from the aorta (Ao) and crossing the UPJ. Kd = kidney, Lt = left, RP = renal pelvis, RtPo = right posterior, U = ureter.

View larger version (108K): [in a new window]   Figure 1d.   Posterior crossing artery associated with UPJ obstruction in a 40-year-old woman. (a) Axial CT scans (left image obtained at a higher level than right image) show a dilated right renal pelvis (arrows) and a crossing vessel (arrowheads). (b) Axial CT scans show planes used for coronal (left image) and curved (right image) reconstruction. U = ureter. (c) Coronal image reconstructed along the straight line in b shows the small vessel (arrow) adjacent to the most stenotic point of the UPJ. Ao = aorta, Kd = kidney, Lt = left, RP = renal pelvis, Rt = right, U = ureter. (d) Curved image reconstructed along the course of the crossing vessel (curved line in b) shows the small vessel (arrows) branching from the aorta (Ao) and crossing the UPJ. Kd = kidney, Lt = left, RP = renal pelvis, RtPo = right posterior, U = ureter.

View larger version (149K): [in a new window]   Figure 2a.   Anterior crossing vein associated with UPJ obstruction in a 31-year-old man. (a) Urogram shows left hydronephrosis. (b) Axial CT scans show the dilated left renal pelvis (left image) and a crossing vessel (arrows in right image). (c) Sagittal image reconstructed along the line in b shows the adjacent crossing vessel (arrow) anterior to the UPJ obstruction. An = anterior, Po = posterior, RP = renal pelvis, U = ureter.

View larger version (117K): [in a new window]   Figure 2b.   Anterior crossing vein associated with UPJ obstruction in a 31-year-old man. (a) Urogram shows left hydronephrosis. (b) Axial CT scans show the dilated left renal pelvis (left image) and a crossing vessel (arrows in right image). (c) Sagittal image reconstructed along the line in b shows the adjacent crossing vessel (arrow) anterior to the UPJ obstruction. An = anterior, Po = posterior, RP = renal pelvis, U = ureter.

View larger version (113K): [in a new window]   Figure 2c.   Anterior crossing vein associated with UPJ obstruction in a 31-year-old man. (a) Urogram shows left hydronephrosis. (b) Axial CT scans show the dilated left renal pelvis (left image) and a crossing vessel (arrows in right image). (c) Sagittal image reconstructed along the line in b shows the adjacent crossing vessel (arrow) anterior to the UPJ obstruction. An = anterior, Po = posterior, RP = renal pelvis, U = ureter.

View larger version (139K): [in a new window]   Figure 3a.   Posterior crossing vein associated with UPJ obstruction in a 60-year-old man. (a) Axial CT scan shows a dilated right renal pelvis. (b) Axial CT scans obtained at a lower level than a show a crossing vessel (arrowheads in left image) and a plane used for oblique sagittal reconstruction (right image). (c) Oblique sagittal image reconstructed along the line in b shows the small vessel (arrow) adjacent to the most stenotic point of the UPJ; this vessel is suspected of compressing the UPJ. AnRt = anterior right, Kd = kidney, PoLt = posterior left, RP = renal pelvis, U = ureter. (d) Axial CT scans (shown from superior [left image] to inferior [right image]) show that enhancement disappears proximal to the crossing vessel (arrow). RA = renal artery.

View larger version (106K): [in a new window]   Figure 3b.   Posterior crossing vein associated with UPJ obstruction in a 60-year-old man. (a) Axial CT scan shows a dilated right renal pelvis. (b) Axial CT scans obtained at a lower level than a show a crossing vessel (arrowheads in left image) and a plane used for oblique sagittal reconstruction (right image). (c) Oblique sagittal image reconstructed along the line in b shows the small vessel (arrow) adjacent to the most stenotic point of the UPJ; this vessel is suspected of compressing the UPJ. AnRt = anterior right, Kd = kidney, PoLt = posterior left, RP = renal pelvis, U = ureter. (d) Axial CT scans (shown from superior [left image] to inferior [right image]) show that enhancement disappears proximal to the crossing vessel (arrow). RA = renal artery.

View larger version (95K): [in a new window]   Figure 3c.   Posterior crossing vein associated with UPJ obstruction in a 60-year-old man. (a) Axial CT scan shows a dilated right renal pelvis. (b) Axial CT scans obtained at a lower level than a show a crossing vessel (arrowheads in left image) and a plane used for oblique sagittal reconstruction (right image). (c) Oblique sagittal image reconstructed along the line in b shows the small vessel (arrow) adjacent to the most stenotic point of the UPJ; this vessel is suspected of compressing the UPJ. AnRt = anterior right, Kd = kidney, PoLt = posterior left, RP = renal pelvis, U = ureter. (d) Axial CT scans (shown from superior [left image] to inferior [right image]) show that enhancement disappears proximal to the crossing vessel (arrow). RA = renal artery.

View larger version (85K): [in a new window]   Figure 3d.   Posterior crossing vein associated with UPJ obstruction in a 60-year-old man. (a) Axial CT scan shows a dilated right renal pelvis. (b) Axial CT scans obtained at a lower level than a show a crossing vessel (arrowheads in left image) and a plane used for oblique sagittal reconstruction (right image). (c) Oblique sagittal image reconstructed along the line in b shows the small vessel (arrow) adjacent to the most stenotic point of the UPJ; this vessel is suspected of compressing the UPJ. AnRt = anterior right, Kd = kidney, PoLt = posterior left, RP = renal pelvis, U = ureter. (d) Axial CT scans (shown from superior [left image] to inferior [right image]) show that enhancement disappears proximal to the crossing vessel (arrow). RA = renal artery.

View larger version (109K): [in a new window]   Figure 4a.   Anterior crossing artery and vein associated with UPJ obstruction in a 29-year-old woman. (a) Axial CT scans (left image obtained at a higher level than right image) show right hydronephrosis (left image) and a crossing vessel (arrowheads in right image). (b) Axial CT scans show planes used for oblique sagittal (left image) and curved (right image) reconstruction. (c) Oblique sagittal image reconstructed along the straight line in b shows two anterior crossing vessels (arrows) adjacent to the most stenotic point of the UPJ. AnLt = anterior left, Kd = kidney, PoRt = posterior right, RP = renal pelvis, U = ureter. (d) Curved image reconstructed along the course of the UPJ (curved line in b) shows two crossing vessels (arrows) anteromedial to the UPJ. Kd = kidney, LtAn = left anterior, RP = renal pelvis, RtPo = right posterior, U = ureter. (e) Other oblique sagittal images (shown from anterolateral [left image] to posteromedial [right image]) show two distinct vessels (arrows).

View larger version (110K): [in a new window]   Figure 4b.   Anterior crossing artery and vein associated with UPJ obstruction in a 29-year-old woman. (a) Axial CT scans (left image obtained at a higher level than right image) show right hydronephrosis (left image) and a crossing vessel (arrowheads in right image). (b) Axial CT scans show planes used for oblique sagittal (left image) and curved (right image) reconstruction. (c) Oblique sagittal image reconstructed along the straight line in b shows two anterior crossing vessels (arrows) adjacent to the most stenotic point of the UPJ. AnLt = anterior left, Kd = kidney, PoRt = posterior right, RP = renal pelvis, U = ureter. (d) Curved image reconstructed along the course of the UPJ (curved line in b) shows two crossing vessels (arrows) anteromedial to the UPJ. Kd = kidney, LtAn = left anterior, RP = renal pelvis, RtPo = right posterior, U = ureter. (e) Other oblique sagittal images (shown from anterolateral [left image] to posteromedial [right image]) show two distinct vessels (arrows).

View larger version (139K): [in a new window]   Figure 4c.   Anterior crossing artery and vein associated with UPJ obstruction in a 29-year-old woman. (a) Axial CT scans (left image obtained at a higher level than right image) show right hydronephrosis (left image) and a crossing vessel (arrowheads in right image). (b) Axial CT scans show planes used for oblique sagittal (left image) and curved (right image) reconstruction. (c) Oblique sagittal image reconstructed along the straight line in b shows two anterior crossing vessels (arrows) adjacent to the most stenotic point of the UPJ. AnLt = anterior left, Kd = kidney, PoRt = posterior right, RP = renal pelvis, U = ureter. (d) Curved image reconstructed along the course of the UPJ (curved line in b) shows two crossing vessels (arrows) anteromedial to the UPJ. Kd = kidney, LtAn = left anterior, RP = renal pelvis, RtPo = right posterior, U = ureter. (e) Other oblique sagittal images (shown from anterolateral [left image] to posteromedial [right image]) show two distinct vessels (arrows).

View larger version (157K): [in a new window]   Figure 4d.   Anterior crossing artery and vein associated with UPJ obstruction in a 29-year-old woman. (a) Axial CT scans (left image obtained at a higher level than right image) show right hydronephrosis (left image) and a crossing vessel (arrowheads in right image). (b) Axial CT scans show planes used for oblique sagittal (left image) and curved (right image) reconstruction. (c) Oblique sagittal image reconstructed along the straight line in b shows two anterior crossing vessels (arrows) adjacent to the most stenotic point of the UPJ. AnLt = anterior left, Kd = kidney, PoRt = posterior right, RP = renal pelvis, U = ureter. (d) Curved image reconstructed along the course of the UPJ (curved line in b) shows two crossing vessels (arrows) anteromedial to the UPJ. Kd = kidney, LtAn = left anterior, RP = renal pelvis, RtPo = right posterior, U = ureter. (e) Other oblique sagittal images (shown from anterolateral [left image] to posteromedial [right image]) show two distinct vessels (arrows).

View larger version (61K): [in a new window]   Figure 4e.   Anterior crossing artery and vein associated with UPJ obstruction in a 29-year-old woman. (a) Axial CT scans (left image obtained at a higher level than right image) show right hydronephrosis (left image) and a crossing vessel (arrowheads in right image). (b) Axial CT scans show planes used for oblique sagittal (left image) and curved (right image) reconstruction. (c) Oblique sagittal image reconstructed along the straight line in b shows two anterior crossing vessels (arrows) adjacent to the most stenotic point of the UPJ. AnLt = anterior left, Kd = kidney, PoRt = posterior right, RP = renal pelvis, U = ureter. (d) Curved image reconstructed along the course of the UPJ (curved line in b) shows two crossing vessels (arrows) anteromedial to the UPJ. Kd = kidney, LtAn = left anterior, RP = renal pelvis, RtPo = right posterior, U = ureter. (e) Other oblique sagittal images (shown from anterolateral [left image] to posteromedial [right image]) show two distinct vessels (arrows).

View larger version (104K): [in a new window]   Figure 5a.   Posterior crossing artery and vein in a 5-year-old boy. (a) Axial CT scans (left image obtained at a higher level than right image) show left hydronephrosis (left image) and two crossing vessels (arrowheads in right image). (b) Axial CT scans show planes used for coronal (left image) and sagittal (right image) reconstruction. (c, d) Coronal (c) and sagittal (d) images reconstructed along lines c and d in b, respectively, show a crossing vessel (arrow) adjacent and posteromedial to the UPJ obstruction. On these images, only one crossing vessel is seen. An = anterior, Ao = aorta, Kd = kidney, Lt = left, Po = posterior, RP = renal pelvis, Rt = right, U = ureter. (e, f) Coronal (e) and sagittal (f) images reconstructed along lines e and f in b, respectively, show two vessels (arrows). An = anterior, Ao = aorta, Kd = kidney, Lt = left, Po = posterior, RP = renal pelvis, Rt = right. Like CT, retroperitoneoscopy also showed that two crossing vessels (artery and vein) were adjacent and posterior to the UPJ and that both vessels were associated with UPJ obstruction.

View larger version (108K): [in a new window]   Figure 5b.   Posterior crossing artery and vein in a 5-year-old boy. (a) Axial CT scans (left image obtained at a higher level than right image) show left hydronephrosis (left image) and two crossing vessels (arrowheads in right image). (b) Axial CT scans show planes used for coronal (left image) and sagittal (right image) reconstruction. (c, d) Coronal (c) and sagittal (d) images reconstructed along lines c and d in b, respectively, show a crossing vessel (arrow) adjacent and posteromedial to the UPJ obstruction. On these images, only one crossing vessel is seen. An = anterior, Ao = aorta, Kd = kidney, Lt = left, Po = posterior, RP = renal pelvis, Rt = right, U = ureter. (e, f) Coronal (e) and sagittal (f) images reconstructed along lines e and f in b, respectively, show two vessels (arrows). An = anterior, Ao = aorta, Kd = kidney, Lt = left, Po = posterior, RP = renal pelvis, Rt = right. Like CT, retroperitoneoscopy also showed that two crossing vessels (artery and vein) were adjacent and posterior to the UPJ and that both vessels were associated with UPJ obstruction.

View larger version (147K): [in a new window]   Figure 5c.   Posterior crossing artery and vein in a 5-year-old boy. (a) Axial CT scans (left image obtained at a higher level than right image) show left hydronephrosis (left image) and two crossing vessels (arrowheads in right image). (b) Axial CT scans show planes used for coronal (left image) and sagittal (right image) reconstruction. (c, d) Coronal (c) and sagittal (d) images reconstructed along lines c and d in b, respectively, show a crossing vessel (arrow) adjacent and posteromedial to the UPJ obstruction. On these images, only one crossing vessel is seen. An = anterior, Ao = aorta, Kd = kidney, Lt = left, Po = posterior, RP = renal pelvis, Rt = right, U = ureter. (e, f) Coronal (e) and sagittal (f) images reconstructed along lines e and f in b, respectively, show two vessels (arrows). An = anterior, Ao = aorta, Kd = kidney, Lt = left, Po = posterior, RP = renal pelvis, Rt = right. Like CT, retroperitoneoscopy also showed that two crossing vessels (artery and vein) were adjacent and posterior to the UPJ and that both vessels were associated with UPJ obstruction.

View larger version (158K): [in a new window]   Figure 5d.   Posterior crossing artery and vein in a 5-year-old boy. (a) Axial CT scans (left image obtained at a higher level than right image) show left hydronephrosis (left image) and two crossing vessels (arrowheads in right image). (b) Axial CT scans show planes used for coronal (left image) and sagittal (right image) reconstruction. (c, d) Coronal (c) and sagittal (d) images reconstructed along lines c and d in b, respectively, show a crossing vessel (arrow) adjacent and posteromedial to the UPJ obstruction. On these images, only one crossing vessel is seen. An = anterior, Ao = aorta, Kd = kidney, Lt = left, Po = posterior, RP = renal pelvis, Rt = right, U = ureter. (e, f) Coronal (e) and sagittal (f) images reconstructed along lines e and f in b, respectively, show two vessels (arrows). An = anterior, Ao = aorta, Kd = kidney, Lt = left, Po = posterior, RP = renal pelvis, Rt = right. Like CT, retroperitoneoscopy also showed that two crossing vessels (artery and vein) were adjacent and posterior to the UPJ and that both vessels were associated with UPJ obstruction.

View larger version (130K): [in a new window]   Figure 5e.   Posterior crossing artery and vein in a 5-year-old boy. (a) Axial CT scans (left image obtained at a higher level than right image) show left hydronephrosis (left image) and two crossing vessels (arrowheads in right image). (b) Axial CT scans show planes used for coronal (left image) and sagittal (right image) reconstruction. (c, d) Coronal (c) and sagittal (d) images reconstructed along lines c and d in b, respectively, show a crossing vessel (arrow) adjacent and posteromedial to the UPJ obstruction. On these images, only one crossing vessel is seen. An = anterior, Ao = aorta, Kd = kidney, Lt = left, Po = posterior, RP = renal pelvis, Rt = right, U = ureter. (e, f) Coronal (e) and sagittal (f) images reconstructed along lines e and f in b, respectively, show two vessels (arrows). An = anterior, Ao = aorta, Kd = kidney, Lt = left, Po = posterior, RP = renal pelvis, Rt = right. Like CT, retroperitoneoscopy also showed that two crossing vessels (artery and vein) were adjacent and posterior to the UPJ and that both vessels were associated with UPJ obstruction.

View larger version (151K): [in a new window]   Figure 5f.   Posterior crossing artery and vein in a 5-year-old boy. (a) Axial CT scans (left image obtained at a higher level than right image) show left hydronephrosis (left image) and two crossing vessels (arrowheads in right image). (b) Axial CT scans show planes used for coronal (left image) and sagittal (right image) reconstruction. (c, d) Coronal (c) and sagittal (d) images reconstructed along lines c and d in b, respectively, show a crossing vessel (arrow) adjacent and posteromedial to the UPJ obstruction. On these images, only one crossing vessel is seen. An = anterior, Ao = aorta, Kd = kidney, Lt = left, Po = posterior, RP = renal pelvis, Rt = right, U = ureter. (e, f) Coronal (e) and sagittal (f) images reconstructed along lines e and f in b, respectively, show two vessels (arrows). An = anterior, Ao = aorta, Kd = kidney, Lt = left, Po = posterior, RP = renal pelvis, Rt = right. Like CT, retroperitoneoscopy also showed that two crossing vessels (artery and vein) were adjacent and posterior to the UPJ and that both vessels were associated with UPJ obstruction.

View larger version (127K): [in a new window]   Figure 6a.   Anterior and posterior crossing arteries associated with UPJ obstruction in a 26-year-old man. (a) Axial CT scan shows right hydronephrosis. (b) Axial CT scans obtained at a lower level than a show two crossing vessels (arrows in left image) and a plane used for oblique sagittal reconstruction (right image). We confirmed the connection between the two vessels and the aorta by tracing them on many images. (c) Oblique sagittal image reconstructed along the line in b shows one artery located anterior and the other posterior to the UPJ (arrows); the UPJ is sandwiched and compressed between the arteries. AnRt = anterior right, PoLt = posterior left, RP = renal pelvis, U = ureter.

View larger version (108K): [in a new window]   Figure 6b.   Anterior and posterior crossing arteries associated with UPJ obstruction in a 26-year-old man. (a) Axial CT scan shows right hydronephrosis. (b) Axial CT scans obtained at a lower level than a show two crossing vessels (arrows in left image) and a plane used for oblique sagittal reconstruction (right image). We confirmed the connection between the two vessels and the aorta by tracing them on many images. (c) Oblique sagittal image reconstructed along the line in b shows one artery located anterior and the other posterior to the UPJ (arrows); the UPJ is sandwiched and compressed between the arteries. AnRt = anterior right, PoLt = posterior left, RP = renal pelvis, U = ureter.

View larger version (59K): [in a new window]   Figure 6c.   Anterior and posterior crossing arteries associated with UPJ obstruction in a 26-year-old man. (a) Axial CT scan shows right hydronephrosis. (b) Axial CT scans obtained at a lower level than a show two crossing vessels (arrows in left image) and a plane used for oblique sagittal reconstruction (right image). We confirmed the connection between the two vessels and the aorta by tracing them on many images. (c) Oblique sagittal image reconstructed along the line in b shows one artery located anterior and the other posterior to the UPJ (arrows); the UPJ is sandwiched and compressed between the arteries. AnRt = anterior right, PoLt = posterior left, RP = renal pelvis, U = ureter.

View larger version (97K): [in a new window]   Figure 7a.   Posterior crossing artery not associated with UPJ obstruction in a 57-year-old woman. (a) Axial CT scans show a crossing vessel (arrows in left image) adjacent to the UPJ and a plane used for oblique coronal reconstruction (right image). U = ureter. (b) Oblique coronal image reconstructed along the line in a shows left hydronephrosis and the vessel (arrow) crossing adjacent and posterior to the UPJ; however, the vessel is located slightly under the point of UPJ obstruction. LtPo = left posterior, RP = renal pelvis, RtAn = right anterior, U = ureter. (c) Oblique coronal image obtained immediately posteromedial to b shows no crossing vessel at the most stenotic point of the UPJ. Kd = kidney, LtPo = left posterior, RP = renal pelvis, RtAn = right anterior, U = ureter.

View larger version (119K): [in a new window]   Figure 7b.   Posterior crossing artery not associated with UPJ obstruction in a 57-year-old woman. (a) Axial CT scans show a crossing vessel (arrows in left image) adjacent to the UPJ and a plane used for oblique coronal reconstruction (right image). U = ureter. (b) Oblique coronal image reconstructed along the line in a shows left hydronephrosis and the vessel (arrow) crossing adjacent and posterior to the UPJ; however, the vessel is located slightly under the point of UPJ obstruction. LtPo = left posterior, RP = renal pelvis, RtAn = right anterior, U = ureter. (c) Oblique coronal image obtained immediately posteromedial to b shows no crossing vessel at the most stenotic point of the UPJ. Kd = kidney, LtPo = left posterior, RP = renal pelvis, RtAn = right anterior, U = ureter.

View larger version (116K): [in a new window]   Figure 7c.   Posterior crossing artery not associated with UPJ obstruction in a 57-year-old woman. (a) Axial CT scans show a crossing vessel (arrows in left image) adjacent to the UPJ and a plane used for oblique coronal reconstruction (right image). U = ureter. (b) Oblique coronal image reconstructed along the line in a shows left hydronephrosis and the vessel (arrow) crossing adjacent and posterior to the UPJ; however, the vessel is located slightly under the point of UPJ obstruction. LtPo = left posterior, RP = renal pelvis, RtAn = right anterior, U = ureter. (c) Oblique coronal image obtained immediately posteromedial to b shows no crossing vessel at the most stenotic point of the UPJ. Kd = kidney, LtPo = left posterior, RP = renal pelvis, RtAn = right anterior, U = ureter.

View larger version (105K): [in a new window]   Figure 8a.   Posterior crossing vein not associated with UPJ obstruction in a 10-year-old boy. (a) Axial CT scans show a crossing vessel (arrows in left image) posterior to the UPJ and a plane used for sagittal reconstruction (right image). (b) Sagittal image reconstructed along the line in a shows the crossing vessel (arrows) adjacent to the most stenotic point of the UPJ. We therefore suspected that the crossing vessel was associated with UPJ obstruction. However, the vessel was found not to compress the UPJ at retroperitoneoscopy. An = anterior, Kd = kidney, Po = posterior, RP = renal pelvis, U = ureter.

View larger version (123K): [in a new window]   Figure 8b.   Posterior crossing vein not associated with UPJ obstruction in a 10-year-old boy. (a) Axial CT scans show a crossing vessel (arrows in left image) posterior to the UPJ and a plane used for sagittal reconstruction (right image). (b) Sagittal image reconstructed along the line in a shows the crossing vessel (arrows) adjacent to the most stenotic point of the UPJ. We therefore suspected that the crossing vessel was associated with UPJ obstruction. However, the vessel was found not to compress the UPJ at retroperitoneoscopy. An = anterior, Kd = kidney, Po = posterior, RP = renal pelvis, U = ureter.