OBJECTIVES: To evaluate the use of contrast-enhanced helical computed tomography (HCT) scanning with three-dimensional reconstructions as a possible identifier of crossing vessels in ureteropelvic junction (UPJ) obstruction. Endoscopic treatment of @entity4145 has a success rate that approaches 90%. These results drop to 40% in the presence of crossing vessels. Unrecognized crossing vessels can also result in significant @entity548 during endopyelotomy. The presence of crossing vessels is, for many, an indication for open or laparoscopic UPJ repair. Therefore, accurate preoperative imaging is crucial for appropriate treatment planning. METHODS: Our study population consisted of 18 @entity1 evaluated and treated for @entity4145 at the University of Michigan Health System. These @entity1 underwent routine contrast-enhanced preoperative HCT scanning before UPJ repair. A prior history of failed endoscopic treatment, @entity1 preference, and HCT findings of crossing vessels were indications for open or laparoscopic repair. The imaging findings were compared with open findings during laparoscopic or open pyeloplasty. RESULTS: An HCT finding of the presence of crossing vessels was a significant positive predictor, with a value of 100%. The sensitivity in this population was 91% and the specificity was 100%. No difference was noted between the detection of arterial or venous crossing vessels. The positive predictive value was 100%, and the negative predictive value was 88%. CONCLUSIONS: HCT is an accurate predictor of the presence of crossing vessels in @entity4145 . Because crossing vessels may have a profound impact on treatment outcome, HCT can serve as an effective, noninvasive, preoperative screening tool.

Helical computed tomography for identification of crossing vessels in XXXX with operative findings.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity4145 :: ('MESH:C537373', 'Disease') :: ['UPJ obstruction'] @entity548 :: ('MESH:D006470', 'Disease') :: ['hemorrhage']
@entity4145 :: (MESH:C537373,Disease) :: ['ureteropelvic junction obstruction-comparison']
