MyPACS.net: Radiology Teaching Files > Case 7852062

previously visited 070116 LEFT URETEROPELVIC JUNCTION OBSTRUCTION
Contributed by: pedrad CSH, Radiologist, Chung Shan Medical University Hospital, Taiwan.
Patient: 9 year old male
History: Incidental finding during screening echocardiography for congenital vascular ring
Images:[small]larger

Fig. 1: Ultrasound, right flank

Fig. 2: Ultrasound, middle abdomen

Fig. 3: Ultrasound, left flank

Fig. 4: Ultrasound, lower abdomen

Fig. 5: T1 spoiled gradient echo, Coronal

Fig. 6: T2 half-Fourier acquisition single-shot turbo spin echo, Axial_1

Fig. 7: T2 half-Fourier acquisition single-shot turbo spin echo, Axial_2

Fig. 8: T2 half-Fourier acquisition single-shot turbo spin echo, Axial_3

Fig. 9: T2 half-Fourier acquisition single-shot turbo spin echo, Axial_4

Fig. 10: T2/T1 steady-state gradient echo, Axail

Fig. 11: Thick heavily T2 fast spin echo, Projective MR urography

Fig. 12: Thick multi-angles heavily T2 fast spin echo, Projective MR urography

Fig. 13: Heavily T2 half-Fourier acquisition single-shot turbo spin echo with fat suppressed thin images, Coronal

Fig. 14: Heavily T2 half-Fourier acquisition single-shot turbo spin echo with fat suppressed thin image, Maximum-intensity projection reconstruction

Fig. 15: Heavily T2 half-Fourier acquisition single-shot turbo spin echo with fat suppressed thin images, 3D animator

Fig. 16: NM, Dynamic study_1

Fig. 17: NM, Dynamic study_2
Findings:

Figure 1-4(Ultrasound):
1. Normal right kidney.
2. Left severe hydronephrosis with paper-thin of cortex,
   suggesting chronic high-grade obstructive uropathy.
3. Normal right ureter jet by color-Doppler image.
   Non-visualization of left ureter jet.

Figure 5-15 (MR Urography without IV contrast):
1. Marked dilatation of left calyces and renal pelvis with rapid
   tapering at ureteropelvic junction, in favor of ureteropelvic
   junction obstruction (possibly congenital).
2. Paper-thin of left renal cortex, suggesting chronic high-grade
   obstructive uropathy.
3. No abnormal finding in right kidney, right ureter, and bladder.

Figure 16,17(NM):
1. Decreased uptake of left kidney
   MaxCounts(Kcpm) Left/Right=18.09/51.12=0.35

Diagnosis: Left ureteropelvic junction obstruction with chronic high-grade obstructive uropathy
Comments:
No comments posted.
Additional Details:

Case Number: 7852062Last Updated: 01-20-2007
Anatomy: Genitourinary (GU)   Pathology: Congenital
Modality: MR, Nuc Med, US, 3D ReconstructionAccess Level: Readable by all users
Keywords: ureteropelvic junction obstruction, hydronephrosisACR: 813.1452

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