HELICAL CT AND 3D RECONSTRUCTION OF URETEROPELVIC JUNCTION OBSTRUCTION - ACCURACY IN DETECTION OF CROSSING VESSELS

Purpose: The purpose of our study was to evaluate the accuracy of 3D h elical CT and its value in surgical planning for the treatment of uret eropelvic junction obstruction (UPJO). Method: CT scans and 3D reconst ruction of renal vessels and the renal pelvis were performed in 20 cas es of UPJO treated by open surgery. We analyzed scans in search of a v essel at the junction and its position relative to the UPJ. Helical CT scans and 3D reconstructions were correlated with macroscopic surgica l findings. Results: CT scans demonstrated the presence of a UPJO in a ll cases. Crossing vessels were present at the junction in 13 of 20 ca ses. The vessel crossed the junction posteriorly in six cases and ante riorly in seven cases. Macroscopic surgical findings were in agreement with helical CT reconstructions in 100% of the cases. Conclusion: Axi al scans together with 3D reconstruction an an accurate way of detecti ng crossing vessels when UPJO occurs, and the choice of the most adequ ate surgical technique is facilitated.