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Ureteropelvic Junction Obstruction
Alessandro Furlan, MD; Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Ureteropelvic junction (UPJ) obstruction
            • Definitions

              • Functional or anatomic obstruction to urine flow from renal pelvis into ureter at anatomic junction
                • If left untreated, results in symptoms, renal damage, or both

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Arlen AM et al: Magnetic resonance urography for diagnosis of pediatric ureteral stricture. J Pediatr Urol. ePub, 2014
                                          2. Khan F et al: Management of ureteropelvic junction obstruction in adults. Nat Rev Urol. ePub, 2014
                                          3. Lamba R et al: Multidetector CT of vascular compression syndromes in the abdomen and pelvis. Radiographics. 34(1):93-115, 2014
                                          4. Agarwal A et al: Concomitant percutaneous nephrolithotomy and transperitoneal laparoscopic pyeloplasty for ureteropelvic junction obstruction complicated by stones. J Endourol. 22(10):2251-5, 2008
                                          5. Lin L et al: Role of endoluminal sonography in evaluation of obstruction of the ureteropelvic junction. AJR Am J Roentgenol. 191(4):1250-4, 2008
                                          6. Vaarala MH et al: Retrospective analysis of long-term outcomes of 64 patients treated by endopyelotomy in two low-volume hospitals: good and durable results. J Endourol. 22(8):1659-64, 2008
                                          7. Lawler LP et al: Adult ureteropelvic junction obstruction: insights with three-dimensional multi-detector row CT. Radiographics. 25(1):121-34, 2005
                                          8. Khaira HS et al: Helical computed tomography for identification of crossing vessels in ureteropelvic junction obstruction-comparison with operative findings. Urology. 62(1):35-9, 2003
                                          9. Mitsumori A et al: Evaluation of crossing vessels in patients with ureteropelvic junction obstruction by means of helical CT. Radiographics. 20(5):1383-93; discussion 1393-5, 2000
                                          10. Rouviere O et al: Ureteropelvic junction obstruction: use of helical CT for preoperative assessment--comparison with intraarterial angiography. Radiology. 213(3):668-73, 1999
                                          11. Siegel CL et al: Preoperative assessment of ureteropelvic junction obstruction with endoluminal sonography and helical CT. AJR Am J Roentgenol. 168(3):623-6, 1997
                                          12. Quillin SP et al: Helical (spiral) CT angiography for identification of crossing vessels at the ureteropelvic junction. AJR Am J Roentgenol. 166(5):1125-30, 1996
                                          13. Wolf JS Jr et al: Imaging for ureteropelvic junction obstruction in adults. J Endourol. 10(2):93-104, 1996
                                          14. Bagley DH et al: Endoluminal sonography in evaluation of the obstructed ureteropelvic junction. J Endourol. 8(4):287-92, 1994
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Ureteropelvic junction (UPJ) obstruction
                                                    • Definitions

                                                      • Functional or anatomic obstruction to urine flow from renal pelvis into ureter at anatomic junction
                                                        • If left untreated, results in symptoms, renal damage, or both

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Ultrasonographic Findings

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Arlen AM et al: Magnetic resonance urography for diagnosis of pediatric ureteral stricture. J Pediatr Urol. ePub, 2014
                                                                                  2. Khan F et al: Management of ureteropelvic junction obstruction in adults. Nat Rev Urol. ePub, 2014
                                                                                  3. Lamba R et al: Multidetector CT of vascular compression syndromes in the abdomen and pelvis. Radiographics. 34(1):93-115, 2014
                                                                                  4. Agarwal A et al: Concomitant percutaneous nephrolithotomy and transperitoneal laparoscopic pyeloplasty for ureteropelvic junction obstruction complicated by stones. J Endourol. 22(10):2251-5, 2008
                                                                                  5. Lin L et al: Role of endoluminal sonography in evaluation of obstruction of the ureteropelvic junction. AJR Am J Roentgenol. 191(4):1250-4, 2008
                                                                                  6. Vaarala MH et al: Retrospective analysis of long-term outcomes of 64 patients treated by endopyelotomy in two low-volume hospitals: good and durable results. J Endourol. 22(8):1659-64, 2008
                                                                                  7. Lawler LP et al: Adult ureteropelvic junction obstruction: insights with three-dimensional multi-detector row CT. Radiographics. 25(1):121-34, 2005
                                                                                  8. Khaira HS et al: Helical computed tomography for identification of crossing vessels in ureteropelvic junction obstruction-comparison with operative findings. Urology. 62(1):35-9, 2003
                                                                                  9. Mitsumori A et al: Evaluation of crossing vessels in patients with ureteropelvic junction obstruction by means of helical CT. Radiographics. 20(5):1383-93; discussion 1393-5, 2000
                                                                                  10. Rouviere O et al: Ureteropelvic junction obstruction: use of helical CT for preoperative assessment--comparison with intraarterial angiography. Radiology. 213(3):668-73, 1999
                                                                                  11. Siegel CL et al: Preoperative assessment of ureteropelvic junction obstruction with endoluminal sonography and helical CT. AJR Am J Roentgenol. 168(3):623-6, 1997
                                                                                  12. Quillin SP et al: Helical (spiral) CT angiography for identification of crossing vessels at the ureteropelvic junction. AJR Am J Roentgenol. 166(5):1125-30, 1996
                                                                                  13. Wolf JS Jr et al: Imaging for ureteropelvic junction obstruction in adults. J Endourol. 10(2):93-104, 1996
                                                                                  14. Bagley DH et al: Endoluminal sonography in evaluation of the obstructed ureteropelvic junction. J Endourol. 8(4):287-92, 1994