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Congenital Anomalies of the Renal Pelvis and Ureter

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Pediatric Urogenital Radiology

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

Congenital anomalies may involve any level of the collecting system; the most usual presentation is urinary tract dilatation that may already be detected during fetal life. The role of imaging is to determine the origin of the dilatation, i.e., obstructive versus nonobstructive (Table 1 lists the causes of urinary tract dilatation). Other useful information includes the level of the impairment to drainage (so-called obstruction) and its impact on renal function. All these data are important in order to determine the best therapeutic approach.

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References

  • Avni EF, Matos C, Rypens F, Schulman CC (1997) Ectopic vaginal insertion of an upper pole ureter: demonstration by special sequences of magnetic resonance imaging. J Urol 158(5):1931–1932

    Article  CAS  PubMed  Google Scholar 

  • Avni EF, Nicaise N, Hall M et al (2001) The role of MR imaging for the assessment of complicated duplex kidneys in children. Pediatr Radiol 31:215–223

    Article  CAS  PubMed  Google Scholar 

  • Baskin LS, Zderic SA, Snyder HM et al (1994) Primary dilated megaureter: long-term follow-up. J Urol 152:618–621

    Article  CAS  PubMed  Google Scholar 

  • Bellah RD, Long FR, Canning DA (1995) Ureterocele eversion with VUR in duplex kidneys. AJR 165:409–413

    Article  CAS  PubMed  Google Scholar 

  • Blyth B, Passerini-Glazel G, Camuffo C et al (1993) Endoscopic incision of ureteroceles: intravesical versus ectopic. J Urol 149:5556–5560

    Google Scholar 

  • Bomalski MD, Hirsch RB, Bloom DA et al (1997) VUR and UPJ obstruction: association treatment options and outcome. J Urol 157:969–974

    Article  Google Scholar 

  • Borer JG, Bauer SB, Peters CA et al (1998) A single system ectopic ureter draining an ectopic dysplastic kidney. Br J Urol 81:474–478

    Article  CAS  PubMed  Google Scholar 

  • Braveman RM, Lebowitz RL (1991) Occult ectopic ureter in girls: diagnosis with CT. AJR 156:365–366

    Article  Google Scholar 

  • Bude RO, DiPietro MA, Platt JF et al (1992) Age dependency of the renal resistive index in healthy children. Radiology 184:469–473

    Article  CAS  PubMed  Google Scholar 

  • Calder AD, Hiorns MP, Abhyankar A et al (2007) Contrast-enhanced MR angiography for the detection of crossing renal vessels in children with symptomatic UPJ obstruction. Pediatr Radiol 37:356–361

    Article  PubMed  Google Scholar 

  • Cendron M, D’alton ME, Crombleholme TM (1994) Prenatal diagnosis and management of the fetus with hydronephrosis. Semin Perinatol 18:163–181

    PubMed  CAS  Google Scholar 

  • Claudon M, Ben-Sira L, Lebowitz RL (1999) Lower-pole reflux in children: uroradiologic appearances and pitfalls. AJR 172:795–801

    Article  CAS  PubMed  Google Scholar 

  • Claudon M, Durand E, Grenier N, Prigent A et al (2014) Chronic urinary obstruction: evaluation of dynamic contrast-enhanced MR urography. Radiology 2014;273:801–812

    Article  PubMed  Google Scholar 

  • Cope RM, Snow BW (1991) Massive cystic ureteral diverticula in infancy. J Urol 146:575–577

    Article  CAS  PubMed  Google Scholar 

  • Coplen DE, Austin PF, Yan Y, Blanco VM et al (2006) The magnitude of fetal renal pelvic dilatation can identify obstructive postnatal hydronephrosis, and direct post natal evaluation and management. J Urol 176:724–727

    Article  PubMed  Google Scholar 

  • Corrales JG, Elder JS (1996) Segmental multicystic kidney and ipsilateral duplication anomalies. J Urol 155:1398–1401

    Article  CAS  PubMed  Google Scholar 

  • Darge K, Higgins M, Hwang TJ, Delgado J et al (2013) MR and CT in pediatric urology: an imaging overview for daily practice. Radiol Clin N Amer 51:583–598

    Article  PubMed  Google Scholar 

  • Duong HP, Piepsz A, Collier F et al (2013) Predicting the clinical outcome of antenatally detected unilateral pelviureteric junction stenosis. Urology 82:691–696

    Article  PubMed  Google Scholar 

  • Eskild-Jensen A, Gordon I, Piepsz A et al (2004) Interpretation of the renogram: problems and pitfalls in hydronephrosis in children. BJU Int 94:887–892

    Article  PubMed  Google Scholar 

  • Flaschner SC, Mesrobian HJ, Flatt JA et al (1993) Nonobstructive dilatation of upper urinary tract may later convert to obstruction. Urology 42:569–573

    Article  Google Scholar 

  • Frauschner F, Janetschek G, Helweg G et al (1999) Crossing vessels at the UPJ: detection with contrast enhanced color Doppler imaging. Radiology 210:727–731

    Article  Google Scholar 

  • Gharagoloo AM, Lebowitz RL (1995) Detection of a poorly functioning malpositioned kidney with single ectopic ureter. AJR 164:957–961

    Article  Google Scholar 

  • Glassberg KI, Braren V, Duckett JW et al (1984) Suggested terminology for duplex systems, ectopic ureters and ureteroceles. J Urol 132:1153–1154

    Article  CAS  PubMed  Google Scholar 

  • Gordon I, Colarinha P, Piepsz A et al (2001) Guidelines for standard and diuretic renography in children. Eur J Nucl Med 28:BP21–BP30

    PubMed  CAS  Google Scholar 

  • Gordon I, Piepsz A, Sixt R (2011) Guidelines for standard and diuretic renogram in children. Eur J Nucl Med Mol Imaging 38:1175–1188

    Article  PubMed  Google Scholar 

  • Hassan MA (1990) Ureteral triplication with VUR. Urology 30:78–80

    Google Scholar 

  • Herbetko J, Hyde I (1990) Urinary tract dilatation in constipated children. Br J Radiol 63:855–857

    Article  CAS  PubMed  Google Scholar 

  • Ho DS, Jerkins GR, Williams M et al (1995) UPJ obstruction in upper and lower moiety of duplex renal systems. Urology 45:503–506

    Article  CAS  PubMed  Google Scholar 

  • Husmann D, Strand B, Ewalt D et al (1999) Management of ectopic ureterocele associated with renal duplication. J Urol 162:1406–1409

    Article  CAS  PubMed  Google Scholar 

  • Ismaili K, Piepsz A (2013) The antenatal detected pelvi-ureteric junction stenosis: advances in renography and strategy of management. Pediatr Radiol 43:428–435

    Article  PubMed  Google Scholar 

  • Jayanthi VR, Koff SA (1999) Long-term outcome of transurethral puncture of ectopic ureteroceles. J Urol 162:1077–1080

    Article  CAS  PubMed  Google Scholar 

  • Jones JA, Perez-Brayfield MR, Kirsch AJ et al (2004) Renal transit time with MR urography in children. Radiology 233:41–50

    Article  PubMed  Google Scholar 

  • Keller MS, Weiss RM, Rosenfield NS (1993) US evaluation or ureterectasis in children. J Urol 149:553–555

    Article  CAS  PubMed  Google Scholar 

  • Koff SA, Campbell KD (1994) The non-operative management of unilateral hydronephrosis. J Urol 152:593–595

    Article  CAS  PubMed  Google Scholar 

  • Koff SA, Peller PA, Young DC et al (1994) The assessment of obstruction in newborn with unilateral hydronephrosis by measuring the size of the opposite kidney. J Urol 152:596–599

    Article  CAS  PubMed  Google Scholar 

  • Kraus SJ, Lebowitz RL, Royal SA (1999) Renal calculi in children. Pediatr Radiol 29:624–630

    Article  CAS  PubMed  Google Scholar 

  • Lautin EM, Haramati N, Frager D et al (1988) CT diagnosis of circumcaval ureter. AJR 150:591–594

    Article  CAS  PubMed  Google Scholar 

  • Lebowitz RL, Avni EF (1980) Misleading appearances in pediatric uroradiology. Pediatr Radiol 10:15–31

    Article  CAS  PubMed  Google Scholar 

  • Liu AHY, Dhillon HK, Diamond DA et al (1994) Clinical outcome and management of prenatally diagnosed primary megaureters. J Urol 152:614–617

    Article  CAS  PubMed  Google Scholar 

  • Maizels M, Reisman ME, Flom LS et al (1992) Grading nephro-ureteral dilatation detected in the first year of life. J Urol 148:609–614

    Article  CAS  PubMed  Google Scholar 

  • Mandell GA, Snyder HM, Heyman S et al (1986) Association of congenital megacalycosis and ipsilateral segmental megaureter. Pediatr Radiol 17:28–33

    Article  Google Scholar 

  • Matsumoto JS (1986) Acquired lesions involving the ureter in childhood. Semin Roentgen 21:166–167

    Article  Google Scholar 

  • McGrath MA, Estroff J, Lebowitz RL (1987) The coexistence of obstruction at the UPJ and UVJ. AJR 149:403–406

    Article  CAS  PubMed  Google Scholar 

  • Mckie GG, Stephens FD (1975) Duplex kidneys: a correlation of renal dysplasia with position of ureteral orifice. J Urol 114:274–280

    Article  Google Scholar 

  • Nguyen HT, Herndron CD, Cooper C, Gatti J et al (2010) The society for fetal urology consensus statement on the evaluation and management of antenatal hydronephrosis. J Pediatr Urol 6:212–213

    Article  PubMed  Google Scholar 

  • Nogarède C, Tondeur M, Piepsz A (2010) Normalized residual activity and output efficiency in case of early furosemide injection in children. Nucl Med Commun 31:355–358

    PubMed  Google Scholar 

  • Nolte-Ernstig C, Bucker A, Adam GB et al (1998) Gadolinium-enhanced excretory MR urography after low dose diuretic injection. Radiology 209:147–157

    Article  Google Scholar 

  • Nussbaum AR, Lebowitz RL (1983) Interlabial masses in little girls. AJR 141:65–71

    Article  CAS  PubMed  Google Scholar 

  • Oyen R, Gielen J, Baert L et al (1987) CT demonstration of a ureterosciatic hernia. Urol Radiol 9:174–176

    Article  CAS  PubMed  Google Scholar 

  • Palmer LS (2006) Pediatric urologic imaging. Urol Clin N Am 33:409–433

    Article  Google Scholar 

  • Pantuck AJ, Barone JG, Rosenfeld DL, Fleisher MH (1996) Occult bilateral vaginal ureters. Abdom Imag 21:78–80

    Article  CAS  Google Scholar 

  • Patriquin H (1991) Doppler examination of the kidney in infants and children. Urol Radiol 12:220–227

    Article  CAS  PubMed  Google Scholar 

  • Patti G, Menghini ML, Tordini AR et al (2000) The role of the renal resistive index ratio in diagnosing obstruction and in the follow-up of children with unilateral hydronephrosis. BJU Intern 85:308–312

    Article  CAS  Google Scholar 

  • Peerboccus M, Damry N, Pather S et al (2012) The impact of hydration on renal measurements and on cortical echogenicity in children. Pediatr Radiol 43:1557–1565

    Article  Google Scholar 

  • Peppas DS, Skoog SJ, Canning DA et al (1991) Nonsurgical management of VUR in complete ureteral duplication. J Urol 146:1594–1595

    Article  CAS  PubMed  Google Scholar 

  • Peters CA (1995) Urinary tract obstruction in children. J Urol 154:1874–1884

    Article  CAS  PubMed  Google Scholar 

  • Piepsz A, Ham HR (2006) Pediatric applications of renal nuclear medicine. Semin Nucl Med 36:16–35

    Article  PubMed  Google Scholar 

  • Piepsz A, Colarinha P, Gordon I et al (2001) Guidelines for glomerular filtration rate determination in children. Eur J Nucl Med 28:31–36

    Google Scholar 

  • Piepsz A, Kuyvenhoven J, Tondeur HH (2002) Normalized residual activity: usual values and robustness of the method. J Nucl Med 43:33–38

    PubMed  Google Scholar 

  • Piepsz A, Gordon I, Brock J III et al (2009) Round table on the management of renal pelvic dilatation in children. J Pediatr Urol 5:437–444

    Article  PubMed  Google Scholar 

  • Piepsz A (2009) The predictive value of the renogram. Eur J Nucl Med Mol Imaging 36:1661–1664

    Article  PubMed  Google Scholar 

  • Piepsz A (2011) Antenatal detection of pelviureteric junction stenosis: main controversies. Semin Nucl Med 41:11–19

    Article  PubMed  Google Scholar 

  • Piepsz A, Tondeur M, Nogarède C et al (2011) Can severely impaired cortical transit predict which children with pelvi-ureteric junction stenosis detected antenatally might benefit from pyeloplasty? Nucl Med Commun 32:199–205

    Article  PubMed  Google Scholar 

  • Pinter AB, Szabo L, Szever ZS et al (1997) Bilateral congenital segmental megaureter. J Urol 158:570–571

    Article  CAS  PubMed  Google Scholar 

  • Prigent A, Cosgriff P, Gates GF et al (1999) Consensus report on quality control of quantitative measurements of renal function obtained from renogram: International Consensus Committee for the Scientific Committee of Radionuclides in Nephrourology. Semin Nucl Med 29:146–159

    Article  CAS  PubMed  Google Scholar 

  • Regan F, Bohlman ME, Khazan R et al (1996) MR urography using HASTE imaging in the assessment of ureteric obstruction. AJR 167:1115–1120

    Article  CAS  PubMed  Google Scholar 

  • Renjen P, Bellah R, Hellinger JC, Darhe K (2012) Advances in uroradiologic imaging in children. Radiol Clin N Amer 50:207–218

    Article  PubMed  Google Scholar 

  • Riccabona M, Simbrunner J, Ring E, Ebner F, Fotter R (2002) Feasibility of MR-urography in neonates and infants with anomalies of the upper urinary tract. Eur Radiol 12:1442–1450

    Article  CAS  PubMed  Google Scholar 

  • Riccabona M, Avni FE, Blickman JG, Dacher JN et al (2009) Imaging recommendations in pediatric uroradiology: Childhood obstructive uropathy, high grades fetal hydronephrosis and childhood haematuria. Pediatr Radiol 39:891–898

    Article  PubMed  Google Scholar 

  • Riccabona M, Avni FE, Dacher JN, Damasio B et al (2010) Imaging recommendations in pediatric uroradiology: IVU, uro-CT and MR urography. Pediatr Radiol 40:1315–1320

    Article  PubMed  Google Scholar 

  • Rickwood AMK, Godiwalla SY (1997) The natural history of UPJ obstruction in children presenting clinically with the complaint. Br J Urol 80:793–796

    Article  CAS  PubMed  Google Scholar 

  • Roarke MC, Sandler CM (1998) Provocative imaging diuretic renography. Urol Clin N Am 25:227–249

    Article  CAS  Google Scholar 

  • Rohrschneider WK, Haufe S, Clorius JH, Troger J (2003) MR to assess renal function in children. Eu Radiol 13:1033–1045

    Google Scholar 

  • Rypens F, Avni EF, Bank WO et al (1992) The UVJ in children. AJR 158:837–842

    Article  CAS  PubMed  Google Scholar 

  • Schlotmann A, Clorius J, Clorius SN (2009) Diuretic renography in hydronephrosis: renal tissue tracer predicts functional course and thereby need for surgery. Eur J Nucl Med Mol Imaging 36:1665–1673

    Article  PubMed  Google Scholar 

  • Share JC, Lebowitz RL (1989) Ectopic ureterocele without ureteral and calyceal dilatation. AJR 152:567–571

    Article  CAS  PubMed  Google Scholar 

  • Share JC, Lebowitz RL (1990) The unsuspected duplex collecting system. AJR 155:561–564

    Article  CAS  PubMed  Google Scholar 

  • Sheih CP, Li Y, Liao Y, Chiang C (1996) Small ureterocele-like Gartner’s duct cyst associated with ipsilateral renal dysgenesis. J Clin Ultrasound 24:533–535

    Article  CAS  PubMed  Google Scholar 

  • Shekarriz B, Upadhyay J, Flemeing P et al (1999) Long-term outcome based on the initial surgical approach to ureterocele. J Urol 162:1072–1076

    Article  CAS  PubMed  Google Scholar 

  • Sherman C, Winchester P, Brill P et al (1988) Childhood retroperitoneal fibrosis. Pediatr Radiol 18:245–247

    Article  CAS  PubMed  Google Scholar 

  • Silveri M, Adorisio O, Pane A et al (2002) Fetal monolateral urinoma and neonatal renal function outcome in posterior urethral valves obstruction: the pop-off mechanism. Pediatr Med Chir 24:394–395

    PubMed  CAS  Google Scholar 

  • Sourtzis S, Damry N, Janssen F et al (1994) Ureteral quadruplication. Pediatr Radiol 24:604–605

    Article  CAS  PubMed  Google Scholar 

  • Stabin M, Taylor A Jr, Eshima D et al (1992) Radiation Dosimetry for technetium-99m-MAG3, technetium-99m-DTPA, and iodine-131-OIH based on human biodistribution studies. J Nucl Med 33:33–40

    PubMed  CAS  Google Scholar 

  • Stocks A, Richards D, Frentzen B et al (1996) Correlation of prenatal pelvic antero-posterior diameter with outcome in infancy. J Urol 155:1050–1052

    Article  CAS  PubMed  Google Scholar 

  • Tondeur M, Nogarede C, Donoso G, Piepsz A (2013) Inter- and intra-observer reproducibility of quantitative renographic parameters of differential function and renal drainage in children. Scand J Clin Lab Invest 73:414–421

    Article  PubMed  Google Scholar 

  • Trigaux JP, Van Beers B, Delchambre F (1991) Male genital tract malformations associated with ipsilateral renal agenesis. J Clin Ultrasound 19:3–10

    Article  CAS  PubMed  Google Scholar 

  • Tsai JD, Huang FY, Lin C et al (2006) Intermittent hydronephrosis secondary to UPJ obstruction: clinical and imaging features. Pediatrics 117:139–146

    Article  PubMed  Google Scholar 

  • Uhlenhuth E, Amin M, Harty JL et al (1990) Infundibulopelvic dysgenesis: a spectrum of obstructive renal disease. Urology 35:334–337

    Article  CAS  PubMed  Google Scholar 

  • Ulchaker J, Ross J, Alexander F et al (1996) The spectrum of UPJ obstruction occurring in duplicated collecting systems. J Ped Surgery 31:1221–1224

    Article  CAS  Google Scholar 

  • Vargas B, Lebowitz RL (1986) The coexistence of congenital megacalyces and primary megaureter. AJR 147:313–316

    Article  CAS  PubMed  Google Scholar 

  • Vergani P, Ceruti P, Locatelli et al (1999) Accuracy of prenatal US diagnosis of duplex kidney. J Ultrasound Med 18:463–467

    Google Scholar 

  • Veyrac C, Baud C, Lopez C, Couture A et al (2003) The value of color Doppler US for identification of crossing vessels in children with PUJ obstruction. Pediatr Radiol 33:745–751

    Article  PubMed  Google Scholar 

  • Vivier PH, Dolores M, Taylor M, Dacher JN (2010a) MR Urography in children Part 2.: how to use Image MR urography processing software. Pediatr Radiol 40(5):739–746

    Article  PubMed  Google Scholar 

  • Vivier PH, Dolores M, Taylor M et al (2010b) MR urography in children. Part 1: how I do the F0 technique. Pediatr Radiol 40:732–738

    Article  PubMed  Google Scholar 

  • Vivier PH, Storey P, Rusinek H et al (2011) Kidney function: glomerular filtration rate measurement with MR renography in patients with cirrhosis. Radiology 259(2):462–470

    Article  PubMed  Google Scholar 

  • Wilcox D, Mouriquand P (1998) Management of megaureter in children. Eur Urol 34:73–78

    Article  CAS  PubMed  Google Scholar 

  • Wille S, Von Krobloch R, Klose KJ et al (2002) MR urography in pediatric urology. Scand J Urol Nephrol 37:16–21

    Article  Google Scholar 

  • Yagci F, Erbagci A, Sarica K et al (1999) The place of diuretic enhanced Doppler US in distinguishing between obstructive and nonobstructive hydronephrosis in children. Scand J Urol Nephrol 33:382–385

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatric Radiology, Jeanne de Flandre Hospital, Lille University Hospital, 59037, Lille, France

    Freddy Avni MD, PhD

  2. Department of Pediatric Imaging, Jeanne de Flandre Mother and child hospital, Lille University Hospitals, Lille, France

    Elisa Amzallag-Bellenger MD

  3. Department of Radio-Isotopes, CHU Saint-Pierre, Rue Haute 322, 1000, Brussels, Belgium

    Marianne Tondeur MD

  4. Service de radiologie, CHU Charles-Nicolle, 1, rue de Germont, 76031, Rouen Cedex, France

    Pierre-Hugues Vivier MD, PhD

  5. X-Ray Expert, Maison médicale, Hôpital Privé de l’Estuaire, 505, rue Irène-Joliot-Curie, 76620, Le Havre, France

    Pierre-Hugues Vivier MD, PhD

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  1. Freddy Avni MD, PhD
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  2. Elisa Amzallag-Bellenger MD
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  3. Marianne Tondeur MD
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  4. Pierre-Hugues Vivier MD, PhD
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Correspondence to Freddy Avni MD, PhD .

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  1. Division of Pediatric Radiology, University Hospital, LKH Graz, Graz, Austria

    Michael Riccabona

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Avni, F., Amzallag-Bellenger, E., Tondeur, M., Vivier, PH. (2018). Congenital Anomalies of the Renal Pelvis and Ureter. In: Riccabona, M. (eds) Pediatric Urogenital Radiology. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/978-3-319-39202-8_25

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