PMC4531603_01
Excretory urogram after 30 min. shows severe dilatation of the right pelvocalyceal system with cortical thinning and smooth obstruction of the right ureteropelvic junction.
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Excretory urogram revealed a marked right hydronephrosis with dilated calyces due to ureteropelvic junction obstruction (Figure 1).
CTA with a maximum intensity projection technique demonstrates two renal arteries originating from the aorta. An inferior aberrant artery (arrow) is crossing over the ureteropelvic junction.
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Computed tomography angiogram (CTA) clearly displayed the aberrant renal artery which originated from the aorta below the normal right renal artery (Figure 2).
A source image of MR angiogram shows aberrant renal artery (arrow) and extrinsic compression at the right ureteropelvic junction. Dilated pelvocalyceal system ( ) is seen with low signal intensity.
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A source image of magnetic resonance angiogram (MRA) also showed a severe hydronephrosis of the right kidney and smooth obstruction of the right ureteropelvic junction due to extrinsic compression by an aberrant renal artery which originated from the aorta, crossing anteriorly to the ureteropelvic junction (Figure 3).
Retrograde pyelogram demonstrates extrinsic indentation (arrow) at the right ureteropelvic junction with severe hydronephrosis.
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Retrograde pyelogram demonstrated linear indentation of the proximal ureter (Figure 4).
Prefurosemide images reveal marked right pelvocalyceal dilatation with slowly accumulating tracer activity. After intravenous infusion of furosemide, the left renal collecting system shows prompt washout, but tracer continues to accumulate on the right. On time-activity curves, after the furosemide infusion, there is prompt washout of pelvocalyceal activity in the left kidney, but delayed washout in the right kidney.
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After furosemide infusion, the delayed right kidney excretion was somewhat improved (Figure 5).