Related Experiment Videos
Imaging for ureteropelvic junction obstruction in adults
J S Wolf1, C L Siegel, J A Brink
1Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Journal of Endourology
|April 1, 1996
Summary
Diagnosing ureteropelvic junction (UPJ) obstruction involves assessing obstruction, function, and cause. While multiple imaging tests exist, urography and diuretic scintigraphy are often sufficient for adult UPJ obstruction evaluation.
Area of Science:
- Urology
- Radiology
- Medical Imaging
Background:
- Ureteropelvic junction (UPJ) obstruction is a common cause of upper urinary tract obstruction.
- Accurate diagnosis is crucial for appropriate management and preservation of renal function.
Purpose of the Study:
- To outline the goals of imaging in suspected UPJ obstruction.
- To review the various diagnostic techniques available.
- To suggest an appropriate imaging algorithm for adult patients.
Main Methods:
- Review of diagnostic techniques including intravenous urography, ultrasonography with Doppler, diuretic scintigraphy, Whitaker test, voiding cystography, retrograde ureteropyelography, and CT.
- Discussion of methods for identifying causative factors like crossing vessels (angiography, endoluminal ultrasonography, spiral CT).
Main Results:
- Intravenous urography is noted as unreliable.
- Diuretic scintigraphy and pressure-flow studies (Whitaker test) are highlighted for assessing obstruction and renal outflow resistance.
- CT and ultrasonography offer utility in specific cases, particularly for identifying crossing vessels.
Conclusions:
- No single algorithm fits all patients with suspected UPJ obstruction.
- For the average adult patient, intravenous urography and diuretic scintigraphy are generally sufficient for diagnosis.
- Comprehensive evaluation may involve multiple imaging modalities to determine the cause and degree of obstruction.