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Helical computed tomography for identification of crossing vessels in ureteropelvic junction obstruction-comparison with operative findings.

Publication ,  Journal Article
Khaira, HS; Platt, JF; Cohan, RH; Wolf, JS; Faerber, GJ
Published in: Urology
July 2003

OBJECTIVES: To evaluate the use of contrast-enhanced helical computed tomography (HCT) scanning with three-dimensional reconstructions as a possible identifier of crossing vessels in ureteropelvic junction (UPJ) obstruction. Endoscopic treatment of UPJ obstruction has a success rate that approaches 90%. These results drop to 40% in the presence of crossing vessels. Unrecognized crossing vessels can also result in significant hemorrhage during endopyelotomy. The presence of crossing vessels is, for many, an indication for open or laparoscopic UPJ repair. Therefore, accurate preoperative imaging is crucial for appropriate treatment planning. METHODS: Our study population consisted of 18 patients evaluated and treated for UPJ obstruction at the University of Michigan Health System. These patients underwent routine contrast-enhanced preoperative HCT scanning before UPJ repair. A prior history of failed endoscopic treatment, patient preference, and HCT findings of crossing vessels were indications for open or laparoscopic repair. The imaging findings were compared with open findings during laparoscopic or open pyeloplasty. RESULTS: An HCT finding of the presence of crossing vessels was a significant positive predictor, with a value of 100%. The sensitivity in this population was 91% and the specificity was 100%. No difference was noted between the detection of arterial or venous crossing vessels. The positive predictive value was 100%, and the negative predictive value was 88%. CONCLUSIONS: HCT is an accurate predictor of the presence of crossing vessels in UPJ obstruction. Because crossing vessels may have a profound impact on treatment outcome, HCT can serve as an effective, noninvasive, preoperative screening tool.

Duke Scholars

Published In

Urology

DOI

EISSN

1527-9995

Publication Date

July 2003

Volume

62

Issue

1

Start / End Page

35 / 39

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Ureteral Obstruction
  • Ureter
  • Tomography, Spiral Computed
  • Sensitivity and Specificity
  • Retrospective Studies
  • Preoperative Care
  • Predictive Value of Tests
  • Minimally Invasive Surgical Procedures
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Khaira, H. S., Platt, J. F., Cohan, R. H., Wolf, J. S., & Faerber, G. J. (2003). Helical computed tomography for identification of crossing vessels in ureteropelvic junction obstruction-comparison with operative findings. Urology, 62(1), 35–39. https://doi.org/10.1016/s0090-4295(03)00156-0
Khaira, Herkanwal S., Joel F. Platt, Richard H. Cohan, J Stuart Wolf, and Gary J. Faerber. “Helical computed tomography for identification of crossing vessels in ureteropelvic junction obstruction-comparison with operative findings.Urology 62, no. 1 (July 2003): 35–39. https://doi.org/10.1016/s0090-4295(03)00156-0.
Khaira, Herkanwal S., et al. “Helical computed tomography for identification of crossing vessels in ureteropelvic junction obstruction-comparison with operative findings.Urology, vol. 62, no. 1, July 2003, pp. 35–39. Pubmed, doi:10.1016/s0090-4295(03)00156-0.
Journal cover image

Published In

Urology

DOI

EISSN

1527-9995

Publication Date

July 2003

Volume

62

Issue

1

Start / End Page

35 / 39

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Ureteral Obstruction
  • Ureter
  • Tomography, Spiral Computed
  • Sensitivity and Specificity
  • Retrospective Studies
  • Preoperative Care
  • Predictive Value of Tests
  • Minimally Invasive Surgical Procedures
  • Male