Ling Lin MD, Abstract Co-Author: Nothing to Disclose

Demetrius H. Bagley MD, Abstract Co-Author: Nothing to Disclose

Ji-Bin Liu MD, Presenter: Nothing to Disclose

The objective of this study is to demonstrate clinical usefulness of 2D and 3D endoluminal ultrasound (US) imaging in patients with an obstructed ureteropelvic junction (UPJ) during endourologic procedures.

In 45 patients with an obstructed UPJ undergoing endoscopic procedures, a 6.2 French catheter-based US probe (12.5 or 20 MHz) was inserted under endoscopic guidance into the upper urinary tract to obtain 2D images for evaluation of UPJ structures and construct into 3D volume images using a computer workstation. The role of the 3D imaging in addition to 2D imaging for identification of abnormalities at the UPJ was evaluated.

Both 2D and 3D images identified crossing vessels at the UPJ in 55.8 % (24/43) patients or a ureteral septum in 32.6 % (14/43) patients and successfully guided incision sites. When 2D cross-sectional images are reconstructed into a 3D display, it can be viewed from any image plane at selected sites. The anatomic structures of the UPJ associated with abnormalities (e.g., crossing vessels, septum, calculi, tumors or strictures) can be appreciated and evaluated more fully as a 3D representation compared to 2D imaging. Endoluminal US findings ruled out or modified the interventional procedure (endopyelotomy or balloon ureteroplasty) in 18.6 % (8/43) patients.

3D endoluminal US provides intuitive display and additional diagnostic information complementary to 2D imaging and enhances the assessment of normal and abnormal structures at the UPJ for endourologic surgery.

2D reconstructed 3D imaging allows better appreciation of the anatomy and pathology which enhanced the clinical applications for guiding and monitoring endourological interventional procedures.

Lin, L, Bagley, D, Liu, J, 2D and 3D Endoluminal Ultrasound: Its Role for Evaluation of the Obstructed Ureteropelvic Junction.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6008927.html