Medical Radiology - Lazar A.P. 2008

Radiological examination of the urogenital system
Developmental anomalies of the urinary system

The most common congenital Anomalies of the Urinary Organs include renal dystopia, Horseshoe Kidney, cystic kidney, duplicated renal pelvis, and duplication of the Ureters.

Developmental anomalies of the urinary organs are clearly visualized using ultrasound, CT, MRI, contrast radiography, and radionuclide imaging techniques.

Dystopia is a congenital low-lying position of the Kidneys. In this condition, the renal pelvis is usually deformed and the Ureter is short, which distinguishes congenital dystopia from a Nephroptosis (floating kidney).

A horseshoe kidney most commonly appears as a horseshoe shape with its hilum facing upward, formed As a result of the fusion of the lower poles of the kidneys. Both renal pelvicalyceal systems are somewhat deformed, symmetrical, and oriented medially and upward. The ureters depart from the pelves at an acute angle and loop over the kidney, which may impair urine outflow.

In cystic kidneys, a significant portion of the renal parenchyma is replaced by fluid-filled cysts. Polycystic Kidney Disease is characterized by The formation of multiple cysts in the renal cortex and is typically a bilateral process. The progressive enlargement of the cysts leads to parenchymal atrophy and renal failure (Fig. 241). Acquired cysts develop in chronic renal failure, prolonged (over 3 years) hemodialysis, etc. A cyst is detected via ultrasound, CT, or MRI as a rounded formation of reduced echogenicity and density, with distinct margins, either lacking a capsule or having a very thin one (Fig. 242).

Class="center">

Fig. 241. Multiple cysts of the right kidney (arrow) on a computed tomography scan.

A duplicated renal pelvis occurs in either normal or hyperplastic kidneys. A ureter originates from each pelvis. In different individuals, these two ureters either merge into a single ureter at various levels or empty separately into the Urinary Bladder. Accordingly, a distinction is made between incomplete duplication of the ureters and complete duplication along their entire length.