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Ureteral Obstruction

  • Chapter
Radiological Imaging of the Ureter

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

Whitaker has suggested a practical and useful defi - nition of urinary tract obstruction: “A narrowing of the urinary tract, such that the proximal pressure must be raised to transmit the usual fl ow through it” (Whitaker 1978b). The key factor of obstruction is blockade of urine fl ow, which leads to increased pressure in the collecting system.

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References

  • Abramson S, Walders N, Applegate KE, et al (2000) Impact in the emergency department of unenhanced CT on diagnostic confidence and therapeutic efficacy in patients with suspected renal colic: a prospective survey. AJR Am J Roentgenol 175:1689–1695

    PubMed  CAS  Google Scholar 

  • Al-Hassan HK, Sabha MN, Taleb HH, et al (1991) Value of ultrasound in persistent flank pain. Int Surg 76:264–265

    PubMed  CAS  Google Scholar 

  • Amis ES Jr, Cronan JJ (1988) The renal sinus: an imaging review and proposed nomenclature for sinus cysts. J Urol 139:1151–1154

    PubMed  Google Scholar 

  • Amis ES Jr, Cronan JJ, Pfister RC, et al (1982) Ultrasonic inaccuracies in diagnosing renal obstruction. Urology 19:101

    Article  PubMed  Google Scholar 

  • Barbaric ZI, Mclntosh PK (1981) Periureteral thin-needle aspiration biopsy. Urol Radiol 2:181–185

    Article  PubMed  CAS  Google Scholar 

  • Bateman GA, Cuganesan R (2002) Renal vein Doppler sonography of obstructive uropathy. AJR Am J Roentgenol 178:921–925

    PubMed  Google Scholar 

  • Bell TV, Fenlon HM, Davison BD, et al (1998) Unenhanced helical CT criteria to differentiate distal ureteral calculi from pelvic phleboliths. Radiology 207:363–367

    PubMed  CAS  Google Scholar 

  • Blake SP, McNicholas MMJ, Raptopoulos V (1998) Nonopaque crystal deposition causing ureteric obstruction in patients with HIV undergoing indinavir therapy. AJR Am J Roentgenol 171:717–720

    PubMed  CAS  Google Scholar 

  • Boridy IC, Kawashima A, Goldman SM, et al (1999a) Acute ureterolithiasis: nonenhanced helical CT findings of perinephric edema for prediction of degree of ureteral obstruction. Radiology 21:663–667

    Google Scholar 

  • Boridy IC, Nikolaidis P, Kawashima A, et al (1999b) Ureterolithiasis: value of the tail sign in differentiating phleboliths from ureteral calculi at nonenhanced helical CT. Radiology 211:619–621

    PubMed  CAS  Google Scholar 

  • Bosniak MA, Megibow AJ, Ambos MA, et al (1982) Computed tomography of ureteral obstruction. AJR Am J Roentgenol 138:1107–1113

    PubMed  CAS  Google Scholar 

  • Burge HJ, Middleton WD, McClennan BL, et al (1991) Ureteral jets in healthy subjects and in patients with unilateral calculi: comparison with color Doppler US. Radiology 180:437–442

    PubMed  CAS  Google Scholar 

  • Catalano C, Papone P, Laghi A, et al (1999) MR pyelography and conventional MR imaging in urinary tract obstruction. Acta Radiol 40:198–200

    Article  PubMed  CAS  Google Scholar 

  • Catalano O, Nunziata A, Altei F, et al (2002) Suspected ureteral colic: primary helical CT versus selective helical CT after unenhanced radiography and sonography. AJR Am J Roentgenol 178:379–387

    PubMed  Google Scholar 

  • Chelfouh N, Grenier N, Migueret D, et al (1998) Characterization of urinary calculi: in vitro study of “twinkling artifact” revealed by color-flow sonography. AJR Am J Roentgenol 171:1055–1060

    PubMed  CAS  Google Scholar 

  • Chen MYM, Zagoria R, Saunders HS, et al (1999) Trends in the use of unenhanced helical CT for acute urinary colic. AJR Am J Roentgenol 173:1447–1450

    PubMed  CAS  Google Scholar 

  • Chu G, Rosenfield AT, Anderson K, et al (1999) Sensitivity and value of digital scout radiography for detecting ureteral stones in patients with ureterolithiasis diagnosed on unenhanced CT. AJR Am J Roentgenol 173:417–423

    PubMed  CAS  Google Scholar 

  • Dalla Palma L, Stacul F, Bazzocchi M, et al (1993) Ultrasonography and plain film versus intravenous urography in ureteric colic. Clin Radiol 47:333–336

    Article  PubMed  CAS  Google Scholar 

  • Dalla Palma L, Pozzi-Mucelli R, Stacul F, et al (2001) Present-day imaging of patients with renal colic. Eur Radiol 11:4–17

    Article  PubMed  CAS  Google Scholar 

  • Djurrhus JC, Stage P (1976) Percutaneous intra-pelvic pressure registration in hydronephrosis during diuresis. Acta Chir Scan [Suppl] 472:49–53

    Google Scholar 

  • Ellenbogen PH, Scheible FW, Talner LB, et al (1978) Sensitivity of gray-sale ultrasound in detecting urinary tract obstruction. AJR Am J Roentgenol 130:731–733

    PubMed  CAS  Google Scholar 

  • Flower CDR (1977) Wide ureters, a dilemma in diagnosis. Br J Radiol 50:539–540

    Article  PubMed  CAS  Google Scholar 

  • Freed KS, Paulson EK, Frederick MG et al (1998) Interobserver variability in the interpretation of unenhanced helical CT for the diagnosis of ureteral stone disease. J Comput Assist Tomogr 22:732–737

    Article  PubMed  CAS  Google Scholar 

  • Friedenberg RM, Moorehouse H, Gade M (1989) Urinomas secondary to pyelosinus backflow. Urol Radiol 5:23–29

    Article  Google Scholar 

  • Gaeta M, Blandino A, Scribano E, et al (1999) Diagnostic pitfalls of breath-hold MR urography in obstructive uropathy. J Comput Assist Tomogr 23:891–897

    Article  PubMed  CAS  Google Scholar 

  • Gillenwater JY (1986) The pathophysiology of urinary obstruction. In: Walsh PC, Gittes R, Perlmutter AD, Stamey TA (eds) Campbell’s urology 5th edn., Saunders, Philadelphia pp 542

    Google Scholar 

  • Grenier N, Pariente JL, Trillaud H, et al (2000) Dilatation of the collecting system during pregnancy: physiologic vs obstructive dilatation. Eur Radiol 10:271–279

    Article  PubMed  CAS  Google Scholar 

  • Guest AR, Cohan RH, Korobkin M, et al (2001) Assessment of the clinical utility of the rim and comet-tail signs in differentiating ureteral stones from phleboliths. AJR Am J Roentgenol 177:1285–1291

    PubMed  CAS  Google Scholar 

  • Haddad MC, Sharif HS, Shahed MS, et al. (1992) Renal colic: diagnosis and outcome. Radiology 184:83–88

    PubMed  CAS  Google Scholar 

  • Hamilton S, Fitzpatrick JM (1987) Primary nonobstructive megaureter in adults: Clin Radiol 38:181–185

    Article  PubMed  CAS  Google Scholar 

  • Harrison BR, Ramchandani P, Allen JT (1979) Psychogenic polydipsia: unusual cause for hydronephrosis. AJR Am J Roentgenol 133:327–328

    PubMed  CAS  Google Scholar 

  • Heneghan JP, Dalrymple NC, Verga M, et al (1997) Soft-tissue „rim” sign in the diagnosis of ureteral calculi with use of unenhanced helical CT. Radiology 202:709–711

    PubMed  CAS  Google Scholar 

  • Herring LC (1962) Observations on the analysis of ten thousand urinary calculi. J Urol 88:545–562

    PubMed  CAS  Google Scholar 

  • Hill MC, Rich JI, Mardiaty JG, et al (1985) Sonography vs. excretory urography in acute flank pain. AJR Am J Roentgenol 144:1235–1238

    PubMed  CAS  Google Scholar 

  • Hodson CJ, Craven JD, Lewis DG, et al (1969) Experimental obstructive nephropathy in the pig. Br J Urol [Suppl] 41:5

    Article  PubMed  Google Scholar 

  • Hussain S, O’Malley M, Jara H, et al (1997) MR urography. MRI Clin North Am 1:95–106

    Google Scholar 

  • Joffre F, Plante P, Tregant P (1990) Techniques d’opacification des voies excrétrices supérieures. Editions techniques. Encycl Med Chir, Paris, France. Radiodiagnostic V 34015 BIO 12; 1–6

    Google Scholar 

  • Katz DS, Lane MJ, Sommer FG (1994) Unenhanced helical CT of ureteral stones: incidences of associated urinary tract findings. AJR Am J Roentgenol 166:1319–1322

    Google Scholar 

  • Kawashima A, Sandier CM, Boridy IC, et al (1997) Unenhanced helical CT of ureterolithiasis: value of the tissue rim sign. AJR Am J Roentgenol 168:997–1000

    PubMed  CAS  Google Scholar 

  • Kerr WS Jr (1956) Effects of complete ureteral obstruction in dogs on kidney function. Am J Physiol 184:521

    PubMed  Google Scholar 

  • Kikinis R, von Schulthess GK, Jager P, et al. (1987) Normal and hydronephrosis kidney: evaluation of renal function with contrast-enhanced MR imaging. Radiology 165:837

    PubMed  CAS  Google Scholar 

  • Klahr S (1991) Pathophysiology of obstructive nephropathy: a 1991 update. Semin Nephrol 11:156–168

    PubMed  CAS  Google Scholar 

  • Knesplova L, Krestin GP (1998) Magnetic resonance in the assessment of renal function. Eur Radiol 8:201–211

    Article  PubMed  CAS  Google Scholar 

  • Laing FC, Jeffrey B Jr, Wing VW (1985) Ultrasound versus excretory urography in evaluating acute flank plain. Radiology 154:613–616

    PubMed  CAS  Google Scholar 

  • Laing FC, Benson CB, Disalvo DN, et al (1994) Distal ureteral calculi: detection with vaginal US. Radiology 192:545–548

    PubMed  CAS  Google Scholar 

  • Lemaitre L, Ala Edine C, Dubrulle F, et al (2000) Retroperitoneum and ureters. In: Terrier Grossholz M, Becker CD (eds) Spiral CT of the abdomen. Springer-Verlag, Berlin Heidelberg New York

    Google Scholar 

  • Lerner RM, Rubens D (1986) Distal ureteral calculi: diagnosis by transrectal sonography. AJR Am J Roentgenol 147:1189–1191

    PubMed  CAS  Google Scholar 

  • Levine JA, Nietlich J, Verga M, et al (1997) Ureteral calculi in patients with flank pain: correlation of plain film radiography with unenhanced helical CT. Radiology 204:27–31

    PubMed  CAS  Google Scholar 

  • Levine J, Neitlich J, Smith RC (1999) The value of prone scanning to distinguish ureterovesical junction stones from ureteral stones that have passed into the bladder: leave no stone unturned. AJR Am J Roentgenol 172:977–981

    PubMed  CAS  Google Scholar 

  • Li W, Chavez D, Edelman PR, et al (1997) Magnetic resonance urography by breath-hold contrast three-dimensional FISP. J Magn Reson Imaging 7:309–311

    Article  PubMed  CAS  Google Scholar 

  • Maillet PS, Pelle-Francoz DP, Laville M, et al (1986) Nondilated obstructive acute renal failure: diagnostic procedures and therapeutic management. Radiology 160:659

    PubMed  CAS  Google Scholar 

  • Mallek P, Bankier AA, Etele-Hainz A, et al (1996) Distinction between obstructive and nonobstructive hydronephrosis: value of diuresis duplex Doppler sonography. AJR Am J Roentgenol 66:113–117

    Google Scholar 

  • Megibow AJ, Mitnick JS, Bosniak MA (1982) The contribution of computed tomography to the evaluation of the obstructed ureter. Urol Radiol 4:95

    Article  PubMed  CAS  Google Scholar 

  • Morse RM, Resnick MI (1991) Ureteral calculi: natural history and treatment in an era of advanced technology. J Urol 145:263–265

    PubMed  CAS  Google Scholar 

  • Mostafavy MR, Ernst RD, Saltzman B (1998) Accurate determination of chemical composition of urinary calculi by spiral computerized tomography. J Urol 159:673–675

    Article  Google Scholar 

  • Mostbeck GH, Zontsich T, Turetschek K (2001) Ultrasound of the kidney: obstruction and medical diseases. Eur Radiol 11:1878–1889

    Article  PubMed  CAS  Google Scholar 

  • Nolte-Ernsting CC, Bucker A, Adam GB, et al (1998) Gadolinium-enhanced excretory MR urography after lowdose diuretic injection: comparison with conventional excretory urography. Radiology 209:147–157

    PubMed  CAS  Google Scholar 

  • Olcott EW, Sommer FG, Napel S (1997) Accuracy of detection and measurement of renal calculi: in vitro comparison of three-dimensional spiral CT, radiography, and nephrotomography. Radiology 204:19–25

    PubMed  CAS  Google Scholar 

  • Onishi K, Watanabe H, Ohe H, et al (1986) Ultrasound finding is urolithiasis in the lower ureter. Ultrasound Med Biol 12:577–579

    Article  Google Scholar 

  • O’Reilly P, Rickards D (1986) Radiology. In: O’Reilly P (ed) Obstructive uropathy. Springer-Verlag, Berlin Heidelberg New York, pp 31–57

    Chapter  Google Scholar 

  • Otal P, Irsutti M, Chabbert V, et al (2001) Exploration radiologique de la colique néphrétique. J Radiol 82:27–33

    PubMed  CAS  Google Scholar 

  • Pfister RC, Newhouse JH (1978) Radiology of the ureter. Urology 12:15–39

    Article  PubMed  CAS  Google Scholar 

  • Pfister RC, McLoughlin AP, Leadbetter WF (1971) Radiological evaluation of primary megaureter. Radiology 99:503–510

    PubMed  CAS  Google Scholar 

  • Pfister RC, Yoder IL, Newhouse JH (1981) Percutaneous uroradiological procedures. Semin Roentgenol 16:135–151

    Article  PubMed  CAS  Google Scholar 

  • Pfister RC, Papanicolaou N, Yoder IC (1986) The dilated ureter. Semin Roentgenol 21:224–235

    Article  PubMed  CAS  Google Scholar 

  • Platt JF (1996) Urinary obstruction. Radiol Clin North Am 34:1113–1129

    PubMed  CAS  Google Scholar 

  • Platt JF, Rubin JM, Ellis JH (1993) Acute renal obstruction: evaluation with intrarenal duplex Doppler and conventional US. Radiology 186:685–688

    PubMed  CAS  Google Scholar 

  • Regan F, Bohlman ME, Khazan R, et al (1996) MR urography using HASTE imaging in the assessment of ureteric obstruction. AJR Am J Roentgenol 67:1115–1120

    Google Scholar 

  • Regan F, Petronis J, Bohlman ME, et al (1997) Perirenal MR high signal. A new and sensitive indicator of acute ureteric obstruction. Clin Radiol 52:445–450

    Article  PubMed  CAS  Google Scholar 

  • Reuther G, Kiefer B, Wandl E (1997) Visualization of urinary tract dilatation: value of single-shot MR urography. Eur Radiol 7 1266–1281

    Article  Google Scholar 

  • Rohrschneider WK, Becker K, Hoffend J, et al (2000) Combined static-dynamic MR urography for the simultaneous evaluation of morphology and function in urinary tract obstruction. II. Findings in experimentally induced ureteric stenosis (in process citation). Pediatr Radiol 30:523–532

    Article  PubMed  CAS  Google Scholar 

  • Roy C, Saussine C, Jahn C, et al (1994) Evaluation of RARE-MR urography in the assessment of uretero-hydronephrosis. J Comput Assist Tomog 18:601–608

    Article  CAS  Google Scholar 

  • Roy C, Saussine C, Guth S, et al (1998) MR urography in the evaluation of the urinary tract obstruction. Abdom Imaging 23:27–34

    Article  PubMed  CAS  Google Scholar 

  • Shapiro SR, Woerner S, Adelman RD, et al (1978) Diabetes insipidus and hydronephrosis. J Urol 119:715–719

    PubMed  CAS  Google Scholar 

  • Sheley RC, Semonsen KG, Quinn SF (1999) Helical CT in the evaluation of renal colic. Am J Emerg Med 17:279–282

    Article  PubMed  CAS  Google Scholar 

  • Sherwood T (1979) The dilated upper urinary tract. Radiol Clin North Am 17:333–340

    PubMed  CAS  Google Scholar 

  • Shopfner CE (1966) Nonobstructive hydronephrosis and hydroureter. AJR Am J Roentgenol 98:172–180

    CAS  Google Scholar 

  • Smith ED, et al (1977) Report of working party to establish an international nomenclature for the large ureter. In: Bergsma D, Duckett JW (eds) Birth defects: original article series vol 13, no 5. Alan R. Liss, New York, for the National Foundation March of Dimes, pp 3–8

    Google Scholar 

  • Smith RC, Rosenfield AT, Choe KA, et al (1995) Acute flank pain: comparison of non-contrast-enhanced CT and intravenous urography. Radiology 194:789–794

    PubMed  CAS  Google Scholar 

  • Smith RC, Verga M, Dalrymple N, et al (1996) Acute ureteral obstruction: value of secondary signs on helical unenhanced CT. AJR Am J Roentgenol 167:1109–1113

    PubMed  CAS  Google Scholar 

  • Soyer P, Levesque M, Lecloirec A, et al (1990) Évaluation du rôle de l’échographie dans le diagnostic positif de colique néphrétique d’origine lithiasique. J Radiol 71:445–450

    PubMed  CAS  Google Scholar 

  • Sourtzis S, Thibeau JF, Damry N, et al (1999) Radiologic investigation of renal colic: unenhanced helical CT compared with excretory urography. AJR Am J Roentgenol 172:1491–1494

    PubMed  CAS  Google Scholar 

  • Sudah M, Vanninen R, Partanen R, et al (2001) MR Urography in evaluation of acute flank pain: T2-weighted sequences and gadolinium-enhanced three-dimensional FLASH compared with urography. AJR Am J Roentgenol 176:105–112

    PubMed  CAS  Google Scholar 

  • Sudah M, Vanninen R, Partanen R, et al (2002) Patients with acute flank pain: comparison of MR urography with unenhanced helical CT. Radiology 223:98–105

    Article  PubMed  Google Scholar 

  • Takahashi N, Kawashima A, Ernst RD, et al (1998) Uretero lithiasias: can clinical outcome be predicted with unenhanced helical CT? Radiology 208:97–102

    PubMed  CAS  Google Scholar 

  • Talner LB (1990a) Specific causes of obstruction. In: Pollack HW (ed) Clinical urography. Saunders, Philadelphia, pp 16–29

    Google Scholar 

  • Talner LB (1990b) Urinary obstruction. In: Pollack HW (ed) Clinical urography. Saunders, Philadelphia pp 15–35

    Google Scholar 

  • Talner LB, Scheible W, Ellenbogen PH, et al (1981) How accurate is ultrasonography in detecting hydronephrosis is azotemic patients? Urol Radiol 3:1–6

    Article  PubMed  CAS  Google Scholar 

  • Traubici J, Neitlich JD, Smith RC (1999) Distinguishing pelvic phleboliths from distal uretral stones on routine unenhanced helical CT: is there a radiolucent center? AJR Am J Roentgenol 172:13–17

    PubMed  CAS  Google Scholar 

  • Tublin ME, Dodd III GD, Verdile VP (1994) Acute renal colic: diagnosis with duplex Doppler US. Radiology 193:697–701

    PubMed  CAS  Google Scholar 

  • Veno A, Kawamura T, Ogawa A, et al (1977) Relation of spontaneous passage of ureteral calculi to size. Urology 10:544–546

    Article  Google Scholar 

  • Whitaker RH (1973) Methods of assessing obstruction in dilated ureters. Br J Urol 45:15–22

    PubMed  CAS  Google Scholar 

  • Whitaker RH (1978a) Clinical assessment of pelvic and ureteral function. Urology 12:146–150

    Article  PubMed  CAS  Google Scholar 

  • Whitaker RH (1978b) Pathophysiology of ureteric obstruction. In: Williams DI, Chisholm GD (eds) Scientific foundations of urology, vol 2, chap 3. Heinemann, London

    Google Scholar 

  • Yilmaz S, Sindel T, Arslan G, et al (1998) Renal colic: comparison of spiral CT, US and IVU in the detection of ureteral calculi. Eur Radiol 8:212–217

    Article  PubMed  CAS  Google Scholar 

  • Zagoria RJ, Khatod EG, Chen MY (2001) Abdominal radiography after CT reveals urinary calculi: a method to predict usefulness of radiography on the basis of size and CT attenuation of calculi. AJR Am J Roentgenol 176:1117–1122

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Service de Radiologie, Hôpital de Rangueil, 1, avenue Jean Poulhès, 31403, Toulouse Cedex 4, France

    T. Smayra MD, Ph. Otal MD, L. Bouchard MD, B. Janne D’Othee MD & F. Joffre MD

  2. Service de Radiologie, CHU Nancy Brabois, rue de Morvan, 54511, Vandoeuvre Les Nancy, France

    F. Lefevre MD, M. Claudon MD & M. Irsutti MD

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    Francis Joffre MD (Professor, Chef de Service), Philippe Otal MD  & Michel Soulie MD (Professor, Chef de Service),  & 

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Smayra, T. et al. (2003). Ureteral Obstruction. In: Joffre, F., Otal, P., Soulie, M. (eds) Radiological Imaging of the Ureter. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55831-3_4

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