Helical CT and 3D reconstruction of ureteropelvic junction obstruction : Accuracy in detection of crossing vessels

The purpose of our study was to evaluate the accuracy of 3D helical CT and its value in surgical planning for the treatment of ureteropelvic junction obstruction (UPJO). CT scans and 3D reconstruction of renal vessels and the renal pelvis were performed in 20 cases of UPJO treated by open surgery. We analyzed scans in search of a vessel at the junction and its position relative to the UPJ. Helical CT scans and 3D reconstructions were correlated with macroscopic surgical findings. CT scans demonstrated the presence of a UPJO in all cases. Crossing vessels were present at the junction in 13 of 20 cases. The vessel crossed the junction posteriorly in six cases and anteriorly in seven cases. Macroscopic surgical findings were in agreement with helical CT reconstructions in 100% of the cases. Axial scans together with 3D reconstruction are an accurate way of detecting crossing vessels when UPJO occurs, and the choice of the most adequate surgical technique is facilitated.