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Megaureter and ureteral valves.

Vincenzo Summaria1, Laura Maria Minordi, Adolfo Canadè

  • 1Istituto di Radiologia, Università Cattolica del S. Cuore, Policlinico A. Gemelli, Largo A. Gemelli 8, 00168 Roma, Italy.

Rays
|April 17, 2003
PubMed
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Primary megaureter, a common urinary tract dilation, is diagnosed using urography and sonography. Imaging reveals characteristic peristalsis patterns and rules out other conditions like vesicoureteral reflux.

Area of Science:

  • Pediatric Urology
  • Diagnostic Imaging
  • Medical Science

Background:

  • Primary megaureter is a congenital condition characterized by ureteral dilation.
  • Accurate diagnosis is crucial for appropriate management and to differentiate from other obstructive uropathies.

Purpose of the Study:

  • To outline the diagnostic imaging features of primary megaureter.
  • To differentiate primary megaureter from other conditions such as prune-belly syndrome and ureteral valves.

Main Methods:

  • Urography with oblique projections to visualize the juxtavesical tract.
  • Sonography and fluoroscopy to assess ureteral peristalsis.
  • Cystography to exclude vesicoureteral reflux.
  • Voiding cystography and retrograde pyelography for suspected ureteral valves.

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Main Results:

  • Primary megaureter shows typical ureteral dilatation, often without significant pyelocaliectasis or tortuosity.
  • Hyperperistalsis in the dilated segment and aperistalsis in the juxtavesical segment are observed.
  • Prune-belly syndrome presents with bilateral, massive megaureters without obstruction.
  • Ureteral valves are suspected with hydronephrosis and absent reflux, visualized as filling defects on urography.

Conclusions:

  • Urography and sonography are key in diagnosing primary megaureter and its associated peristaltic abnormalities.
  • Distinguishing primary megaureter from other conditions like ureteral valves requires specific imaging techniques.
  • Further validation of MR-urography may offer new diagnostic insights.