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Crossing Vessels at the Ureteropelvic Junction: Detection with Contrast-enhanced Color Doppler Imaging

¹ Departments of Radiology II (F.F., G.H., D.z.N.)
² Urology (G.J., H.S., G.B.), University Hospital Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.

View larger version (139K): [in a new window]   Figure 1a. Crossing artery and vein at the UPJ. (a) Pyelogram obtained in a patient in the supine position 30 minutes after the intravenous injection of a contrast agent demonstrates UPJ obstruction (arrow) with severe hydronephrosis on the right side. b–d, C = lower-pole calyx, P = renal pelvis. (b) Longitudinal nonenhanced CDI scan through the dilated collecting system reveals sparse Doppler signals at the level of the UPJ (arrows), without delineation of a crossing vessel. (c) Longitudinal contrast-enhanced CDI scan shows a marked increase in the color Doppler signals, with depiction of two vessels crossing anteriorly to the UPJ. The artery is indicated by the solid arrows, and the vein is indicated by the open arrow. (d) Findings at laparoscopy confirmed the presence of two anteriorly crossing vessels. A retroperitoneoscopic view, with the kidney, renal pelvis, and ureter tilted anteriorly, is shown. A = artery, P = renal pelvis, U = ureter, V = vein.

View larger version (90K): [in a new window]   Figure 1b. Crossing artery and vein at the UPJ. (a) Pyelogram obtained in a patient in the supine position 30 minutes after the intravenous injection of a contrast agent demonstrates UPJ obstruction (arrow) with severe hydronephrosis on the right side. b–d, C = lower-pole calyx, P = renal pelvis. (b) Longitudinal nonenhanced CDI scan through the dilated collecting system reveals sparse Doppler signals at the level of the UPJ (arrows), without delineation of a crossing vessel. (c) Longitudinal contrast-enhanced CDI scan shows a marked increase in the color Doppler signals, with depiction of two vessels crossing anteriorly to the UPJ. The artery is indicated by the solid arrows, and the vein is indicated by the open arrow. (d) Findings at laparoscopy confirmed the presence of two anteriorly crossing vessels. A retroperitoneoscopic view, with the kidney, renal pelvis, and ureter tilted anteriorly, is shown. A = artery, P = renal pelvis, U = ureter, V = vein.

View larger version (99K): [in a new window]   Figure 1c. Crossing artery and vein at the UPJ. (a) Pyelogram obtained in a patient in the supine position 30 minutes after the intravenous injection of a contrast agent demonstrates UPJ obstruction (arrow) with severe hydronephrosis on the right side. b–d, C = lower-pole calyx, P = renal pelvis. (b) Longitudinal nonenhanced CDI scan through the dilated collecting system reveals sparse Doppler signals at the level of the UPJ (arrows), without delineation of a crossing vessel. (c) Longitudinal contrast-enhanced CDI scan shows a marked increase in the color Doppler signals, with depiction of two vessels crossing anteriorly to the UPJ. The artery is indicated by the solid arrows, and the vein is indicated by the open arrow. (d) Findings at laparoscopy confirmed the presence of two anteriorly crossing vessels. A retroperitoneoscopic view, with the kidney, renal pelvis, and ureter tilted anteriorly, is shown. A = artery, P = renal pelvis, U = ureter, V = vein.

View larger version (81K): [in a new window]   Figure 1d. Crossing artery and vein at the UPJ. (a) Pyelogram obtained in a patient in the supine position 30 minutes after the intravenous injection of a contrast agent demonstrates UPJ obstruction (arrow) with severe hydronephrosis on the right side. b–d, C = lower-pole calyx, P = renal pelvis. (b) Longitudinal nonenhanced CDI scan through the dilated collecting system reveals sparse Doppler signals at the level of the UPJ (arrows), without delineation of a crossing vessel. (c) Longitudinal contrast-enhanced CDI scan shows a marked increase in the color Doppler signals, with depiction of two vessels crossing anteriorly to the UPJ. The artery is indicated by the solid arrows, and the vein is indicated by the open arrow. (d) Findings at laparoscopy confirmed the presence of two anteriorly crossing vessels. A retroperitoneoscopic view, with the kidney, renal pelvis, and ureter tilted anteriorly, is shown. A = artery, P = renal pelvis, U = ureter, V = vein.