Skip to main content

Advertisement

SpringerLink
Log in

Role of magnetic resonance urography in pediatric renal fusion anomalies

  • Review
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Renal fusion is on a spectrum of congenital abnormalities that occur due to disruption of the migration process of the embryonic kidneys from the pelvis to the retroperitoneal renal fossae. Clinically, renal fusion anomalies are often found incidentally and associated with increased risk for complications, such as urinary tract obstruction, infection and urolithiasis. These anomalies are most commonly imaged using ultrasound for anatomical definition and less frequently using renal scintigraphy to quantify differential renal function and assess urinary tract drainage. Functional magnetic resonance urography (fMRU) is an advanced imaging technique that combines the excellent soft-tissue contrast of conventional magnetic resonance (MR) images with the quantitative assessment based on contrast medium uptake and excretion kinetics to provide information on renal function and drainage. fMRU has been shown to be clinically useful in evaluating a number of urological conditions. A highly sensitive and radiation-free imaging modality, fMRU can provide detailed morphological and functional information that can facilitate conservative and/or surgical management of children with renal fusion anomalies. This paper reviews the embryological basis of the different types of renal fusion anomalies, their imaging appearances at fMRU, complications associated with fusion anomalies, and the important role of fMRU in diagnosing and managing children with these anomalies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10

Similar content being viewed by others

References

  1. Turkvatan A, Olcer T, Cumhur T et al (2009) Multidetector CT urography of renal fusion anomalies. Diagn Interv Radiol 15:127–134

    PubMed  Google Scholar 

  2. Volkan B, Ceylan E, Kiratli PO et al (2003) Radionuclide imaging of rare congenital renal fusion anomalies. Clin Nucl Med 28:204–207

    PubMed  Google Scholar 

  3. Muttarak M, Sriburi T (2012) Congenital renal anomalies detected in adulthood. Biomed Imaging Interv J 8:e7

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Patel TV, Singh AK (2008) Crossed fused ectopia of the kidneys. Kidney Int 73:662

    Article  CAS  PubMed  Google Scholar 

  5. Friedland GW, de Vries P (1975) Renal ectopia and fusion. Embryologic Basis Urology 5:698–706

    Article  CAS  PubMed  Google Scholar 

  6. Yohannes P, Smith AD (2002) The endourological management of complications associated with horseshoe kidney. J Urol 168:5–8

    Article  PubMed  Google Scholar 

  7. Heredero Zorzo O, Palacios Hernandez A, Eguiluz Lumbreras P et al (2009) Horseshoe kidney rupture. Arch Esp Urol 62:131–133

    PubMed  Google Scholar 

  8. McAleer IM, Kaplan GW, LoSasso BE et al (2002) Congenital urinary tract anomalies in pediatric renal trauma patients. J Urol 168:1808–1810

    Article  PubMed  Google Scholar 

  9. Darge K, Higgins M, Hwang TJ et al (2013) Magnetic resonance and computed tomography in pediatric urology: an imaging overview for current and future daily practice. Radiol Clin N Am 51:583–598

    Article  PubMed  Google Scholar 

  10. Darge K, Anupindi SA, Jaramillo D et al (2011) MR imaging of the abdomen and pelvis in infants, children, and adolescents. Radiology 261:12–29

    Article  PubMed  Google Scholar 

  11. Khrichenko D, Darge K (2010) Functional analysis in MR urography - made simple. Pediatr Radiol 40:182–199

    Article  PubMed  Google Scholar 

  12. Dias T, Sairam S, Kumarasiri S et al (2014) Ultrasound diagnosis of fetal renal abnormalities. Best Pract Res Clin Obstet Gynaecol 28:403–415

    Article  PubMed  Google Scholar 

  13. Rowell AC, Sangster GP, Caraway JD et al (2012) Genitourinary imaging: part 1, congenital urinary anomalies and their management. AJR Am J Roentgenol 199:W545–W553

    Article  PubMed  Google Scholar 

  14. Little M, Georgas K, Pennisi D et al (2010) Kidney development: two tales of tubulogenesis. Curr Top Dev Biol 90:193–229

    Article  CAS  PubMed  Google Scholar 

  15. Michos O (2009) Kidney development: from ureteric bud formation to branching morphogenesis. Curr Opin Genet Dev 19:484–490

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Angtuaco TL, Collins HB, Quirk JG et al (1999) The fetal genitourinary tract. Semin Roentgenol 34:13–28

    Article  CAS  PubMed  Google Scholar 

  17. Cohen HL, Kravets F, Zucconi W et al (2004) Congenital abnormalities of the genitourinary system. Semin Roentgenol 39:282–303

    Article  PubMed  Google Scholar 

  18. Weizer AZ, Silverstein AD, Auge BK et al (2003) Determining the incidence of horseshoe kidney from radiographic data at a single institution. J Urol 170:1722–1726

    Article  PubMed  Google Scholar 

  19. Bozdogan E, Demir M, Konukoglu O et al (2016) Reverse U-shaped horseshoe kidney accompanied by gibbus deformity and spina bifida. Jpn J Radiol 34:448–450

    Article  PubMed  Google Scholar 

  20. Cook WA, Stephens FD (1977) Fused kidneys: morphologic study and theory of embryogenesis. Birth Defects Orig Artic Ser 13:327–340

    CAS  PubMed  Google Scholar 

  21. Natsis K, Piagkou M, Skotsimara A et al (2014) Horseshoe kidney: a review of anatomy and pathology. Surg Radiol Anat 36:517–526

    Article  PubMed  Google Scholar 

  22. Singh SK, Kumar A (2015) Bilateral partial duplex collecting system in horseshoe kidney with stone in the left upper and lower moiety: an unusual association. Saudi J Kidney Dis Transpl 26:608–610

    Article  PubMed  Google Scholar 

  23. Taghavi K, Kirkpatrick J, Mirjalili SA et al (2016) The horseshoe kidney: surgical anatomy and embryology. J Pediatr Urol 12:275–280

    Article  CAS  PubMed  Google Scholar 

  24. O'Brien J, Buckley O, Doody O et al (2008) Imaging of horseshoe kidneys and their complications. J Med Imaging Radiat Oncol 52:216–226

    Article  PubMed  Google Scholar 

  25. Miclaus GD, Pupca G, Gabriel A et al (2015) Right lump kidney with varied vasculature and urinary system revealed by multidetector computed tomographic (MDCT) angiography. Surg Radiol Anat 37:859–865

    Article  PubMed  Google Scholar 

  26. Solanki S, Bhatnagar V, Gupta AK et al (2013) Crossed fused renal ectopia: challenges in diagnosis and management. J Indian Assoc Pediatr Surg 18:7–10

    Article  PubMed  PubMed Central  Google Scholar 

  27. Guarino N, Tadini B, Camardi P et al (2004) The incidence of associated urological abnormalities in children with renal ectopia. J Urol 172:1757–1759

    Article  PubMed  Google Scholar 

  28. Kaur N, Saha S, Mriglani R et al (2013) Crossed fused renal ectopia with a single ureter: a rare anomaly. Saudi J Kidney DisTranspl 24:773–776

    Article  Google Scholar 

  29. Bailey SH, Mone MC, Nelson EW et al (2002) Transplantation of crossed fused ectopic kidneys into a single recipient. J Am Coll Surg 194:147–150

    Article  PubMed  Google Scholar 

  30. Glodny B, Petersen J, Hofmann KJ et al (2009) Kidney fusion anomalies revisited: clinical and radiological analysis of 209 cases of crossed fused ectopia and horseshoe kidney. BJU Int 103:224–235

    Article  PubMed  Google Scholar 

  31. Je BK, Kim HK, Horn PS et al (2015) Incidence and spectrum of renal complications and extrarenal diseases and syndromes in 380 children and young adults with horseshoe kidney. AJR Am J Roentgenol 205:1306–1314

    Article  PubMed  Google Scholar 

  32. Cerwinka WH, Grattan-Smith JD, Jones RA et al (2014) Comparison of magnetic resonance urography to dimercaptosuccinic acid scan for the identification of renal parenchyma defects in children with vesicoureteral reflux. J Pediatr Urol 10:344–351

    Article  CAS  PubMed  Google Scholar 

  33. Ghosh BC, DeSantis M, Kleyner Y et al (2008) Crossed fused renal ectopia with calculi. J Am Coll Surg 206:753

    Article  PubMed  Google Scholar 

  34. Kraft KH, Molitierno JA, Kirsch AJ et al (2007) Ten-year-old girl with crossed-fused ectopic kidney and ectopic ureter to vagina. Urology 70:1220–1221

    Article  PubMed  Google Scholar 

  35. Lin VC, Weng HC, Kian-Lim E et al (2010) An atrophic crossed fused kidney with an ectopic vaginal ureter causing urine incontinence. Urology 76:55–56

    Article  PubMed  Google Scholar 

  36. Dominguez K, Ekeh AP (2011) Blunt trauma causing transection of a horseshoe kidney. J Trauma 71:517

    Article  PubMed  Google Scholar 

  37. Huang EY, Mascarenhas L, Mahour GH et al (2004) Wilms tumor and horseshoe kidneys: a case report and review of the literature. J Pediatr Surg 39:207–212

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Children’s Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA

    Sherwin S. Chan

  2. Division of Body Imaging, Department of Radiology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Aikaterini Ntoulia, Dmitry Khrichenko, Susan J. Back & Kassa Darge

  3. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Susan J. Back, Gregory E. Tasian & Kassa Darge

  4. Division of Urology, Department of Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Gregory E. Tasian

  5. Division of Thoracoabdominal Imaging, Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Jonathan R. Dillman

Authors
  1. Sherwin S. Chan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Aikaterini Ntoulia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dmitry Khrichenko
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Susan J. Back
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gregory E. Tasian
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jonathan R. Dillman
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kassa Darge
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sherwin S. Chan.

Ethics declarations

Conflicts of interest

None

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chan, S.S., Ntoulia, A., Khrichenko, D. et al. Role of magnetic resonance urography in pediatric renal fusion anomalies. Pediatr Radiol 47, 1707–1720 (2017). https://doi.org/10.1007/s00247-017-3927-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-017-3927-5

Keywords

Search

Navigation