Study of pelvicaliceal anatomy by helical computerized tomography. Is it feasible?

OBJECTIVE: To evaluate the role of 3-dimensional images produced by computerized tomography (CT), using intravenous contrast to study pelvicaliceal anatomy. This might be of help in endourological procedures.

METHODS: The study was conducted in King Fahd Hospital of the University, King Faisal University, Dammam, Kingdom of Saudi Arabia. The study took place from July 2002 through to October 2002. Helical CT was carried out for patients who were investigated using excretory urography for any reason, after obtaining a written consent. A CT was carried out to the kidneys only within 10 minutes (between the 5 and 15 minute films of excretory urography). Images were reprocessed by 3-dimension construction after subtracting all structures except for the pelvicaliceal system. Thirty-six normal kidneys were studied.

RESULTS: The upper pole was drained by a single caliceal infundibulum in all 36 (100%) kidneys. The middle segment of the kidney was drained by 2 infundibula in 32 (89%) kidneys. Four (11%) kidneys had no middle caliceal infundibula. The lower pole was drained by 2 caliceal infundibula in 23 (64%) and a single infundibulum in 13 (36%) kidneys. The minor calices draining each renal segment were seen clearly.

CONCLUSION: Three-dimensional images derived by helical CT are feasible for evaluating the anatomy of pelvicaliceal system, and, can be of help in endourological procedures.