Correlation of computerized tomography and intravenous pyelography in the evaluation of pelvicaliceal anatomical measurements

Abstract

Objective: Comparison of computed tomography and reference imaging intravenous pyelography in anatomical measurements of pelvicalyceal system.

Material and Methods: 47 patients and 59 renal units with both computed tomography and intravenous pyelography images were included in the study. The measurements of lower pole infundibulopelvic angle, infundibular length and infundibular width were performed in each kidney and the results were compared between computed tomography and intravenous pyelography groups.

Results: Of the 47 patients who were taken to study, 21 were female and 26 were male. The mean age of the patients was 42.87. Of the 59 renal units, 26 were left, 33 were right kidney. There was no statistically significant difference between the infundibulopelvic angle, infundibular length and infundibular width measurements of the patients measured by computed tomography and intravenous pyelography (p = 0.773, p = 0.931, p = 0.850). It was seen that the measurements of both methods correlated to each other.

Conclusion: With similar results to intravenous pyelography in the anatomical measurements of the pelvicalyceal system, computed tomography may be useful in patients who can not undergo intravenous pyelography imaging for any reason. 

Keywords

• pelvicalyceal anatomy
• intravenous pyelography
• infundibular length and infundibular width
• computed tomography
• infundibulopelvic angle

Pelvikalisiyel Anatomik Ölçümlerin Değerlendirmesinde Bilgisayarlı Tomografi ile İntravenöz Piyelografinin Korelasyonu

Abstract

Amaç: Pelvikalisiyel sistem anatomik ölçümlerinde bilgisayarlı tomografi (BT) ile referans görüntüleme olan intravenöz pyelografinin (İVP) karşılaştırılması.

Gereç ve Yöntemler: Çalışmaya hastanemiz radyoloji kayıtlarında hem BT hem de İVP görüntüleri olan 47 hasta ve 59 renal ünit dahil edildi. Her bir böbreğin alt pol infundibulo- pelvik açı (İPA), infundibuler uzunluk (İU) ve infundibuler genişlik (İG) ölçümleri yapılarak sonuçlar BT ve İVP grupları arasında karşılaş- tırıldı.

Bulgular: Çalışmaya alınan 47 hastanın 21’i kadın, 26’sı erkekti. Hastaların yaş ortalaması 42,87 idi. Elli dokuz renal ünitten 26’sı sol, 33’ü sağ böbrekti. Hastaların İVP ve BT ile ölçülen İPA, İU ve İG ölçümleri arasında istatistiksel fark saptanmadı (p=0.773, p=0.931, p=0.850). Her iki yöntemle de yapılan ölçümlerin birbirine korele olduğu görüldü.

Sonuç: Pelvikalisiyel sistemin anatomik ölçümlerinde İVP ile benzer sonuçları ile BT, her- hangi bir sebeple İVP çekilemeyen hastalarda faydalı olabilir. 

Keywords

• pelvikalisiyel anatomi
• bilgisayarlı tomografi
• intravenöz piyelografi
• infindibulopelvik açı
• infundibuler uzunluk
• infundibuler genişlik

References

1. 1. Lingeman JE, Siegel YI, Steele B, et al. Management of lower pole nephrolithiasis: a critical analysis. J Urol. 1994;151:663-667.
2. 2. Sampaio FJ. Renal collecting system anatomy: its possible role in the effectiveness of renal stone treatment. Curr Opin Urol 2001; 11:359-366.
3. 3. Sumino Y, Mimata H, Tasaki Y, et al. Predictors of lower pole renal stone clearance after extracorporeal shock waveTablo 1. BT ve İVP ile ölçülen İPA, İU ve İG değerlerinin karşılaştırılması lithotripsy. J Urol 2002;168:1344-1347.
4. 4. Madbouly K, Sheir KZ, Elsobky E. Impact of lower pole renal anatomy on stone clearance after shock wave lithotripsy: fact or fiction? J Urol 2001;165:1415-1418.
5. 5. Knoll T, Musial A, Trojan L, et al. Measurements of renal anatomy for prediction of lower-pole caliceal stone clea- rance: reproducibility of different parameters. J Endourol 2003;17:447-445.
6. 6. Sahinkanat T, Ekerbicer H, Onal B, et al. Evaluation of the effects of relationships between main spatial lower pole calyceal anatomic factors on the success of shock-wave lithotripsy in patients with lower pole kidney stones. Urology 2008;71:801-805.
7. 7. Sampaio FJ, Aragao AH. Inferior pole collecting system anatomy: its probable role in extracorporeal shock wave lit- hotripsy. J Urol 1992;147:322-324.
8. 8. Tuckey J, Devasia A, Murthy L, et al. Is there a simpler met- hod for predicting lower pole stone clearance after shock- wave lithotripsy than measuring infundibulopelvic angle? J Endourol 2000;14:475-478.

9. 9. Elbahnasy AM, Shalhav AL, Hoenig DM, et al. Lower cali- ceal stone clearance after shock wave lithotripsy or urete- roscopy: the impact of lower pole radiographic anatomy. J Urol 1998;159:676-682.
10. 10. Breda A, Ogunyemi O, Leppert JT, et al. Flexible ureteros- copy and laser lithotripsy for single intrarenal stones 2 cm or greater—Is this the new frontier? J Urol 2008;179:981- 984.
11. 11. Grasso M, Ficazzola M. Retrograde ureteropyeloscopy for lower pole caliceal calculi. J Urol 1999;162:1904-1908.
12. 12. Geavlete P, Multescu R, Geavlete B. Influence of pyelocali- ceal anatomy on the success of flexible ureteroscopic app- roach. J Endourol 2008;22:2235-2239.
13. 13. Gupta NP, Singh DV, Hemal AK et al. Infundibulopel- vic anatomy and clearance of inferior caliceal calculi with shock wave lithotripsy. J Urol 2000;163:24-27.
14. 14. C. Türk, A. Neisius, A. Petrik, et al. EAU Guidelines on urolithiasis. https://uroweb.org/guideline/urolithiasis 2017
15. 15. Sampaio FJ, D’Anunciacao AL, Silva EC. Comparative follow-up of patients with acute and obtuse infundibulumpelvic angle submitted to extracorporeal shockwave lithot- ripsy for lower caliceal stones: preliminary report and pro- posed study design. J Endourol 1997;11: 157–161.
16. 16. Tan MO, Karaoglan U, Sen I, et al. The impact of radio- logical anatomy in the clearance of lower calyceal stones after shockwave lithotripsy in paediatric patients. Eur Urol 2003;43: 188–193.
17. 17. Keeley FX Jr, Moussa SA, Smith G, et al: Clearance of lo- wer-pole Stones following shock wave lithotripsy: effect of the infundibulopelvic angle. Eur Urol 1999; 36: 371–375.
18. 18. Ghoneim IA, Ziada AM, Elkatib SE. Predictive factors of lower calyceal stone clearance after extracorporeal shock- wave lithotripsy (ESWL): a focus on the infundibulopelvic anatomy. Eur Urol 2005;48: 296–302.
19. 19. Sorensen CM, Chandhoke PS. Is lower pole caliceal ana- tomy predictive of extracorporeal shock wave lithotripsy success for primary lower pole kidney stones? J Urol 2002;168: 2377–2382.
20. 20. Albala DM, Assimos DG, Clayman RV, et a. Lower pole I: a prospective randomized trial of extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy for lower pole nephrolithiasis—initial results. J Urol 2001;166: 2072–2080.
21. 21. Resorlu B, oğuz U, Resorlu EB et al. The impact of pelvi- caliceal anatomy on the success of retrograde intrarenal surgery in patients with lower pole renal stones. Urology 2012;79:61-66.
22. 22. Binbay M, Akman T, Ozgor F et al. Does pelvicaliceal system anatomy affect success of percutaneous nephrolit- hotomy? Urology 2011;78:733-737.
23. 23. Levin DC, Rao VM. Turf wars in radiology: the overutiliza- tion of imaging resulting from self-referral. Journal of the American College of Radiology 2004;1:169-172.
24. 24. Armao D, Semelka RC, Elias J. Radiology’s ethical respon- sibility for healthcare reform: tempering the overutilization of medical imaging and trimming down a heavyweight. Jo- urnal of magnetic resonance imaging 2012;35:512-517.