Crossed renal ectopia with fusion in a female feline: case report / Ectopia renal cruzada com fusão em uma gata: relato de caso

A 3 year old female feline of mixed breed was sent to the diagnostic imaging sector under suspicion of bleeding due to ovariohysterectomy. An abdominal ultrasonography was performed to confirm the initial suspicion. However, no signs of bleeding were found, instead it was observed that the left renal silhouette had two pelvises and was elongated and larger than normal. The right kidney was not found. Excretory urography was requested to evaluate the condition of the ureters. The final diagnosis was crossed renal ectopia with fusion in an asymptomatic cat with no changes in renal function.(AU)

Uma gata, sem raça definida, com três anos de idade, foi encaminhada para o setor de diagnóstico por imagem sob suspeita de hemorragia devido à ovário-histerectomia. Foi realizada ultrasonografia abdominal para confirmar a suspeita inicial, mas nenhum sinal de hemorragia foi encontrado; visibilizou-se, entretanto, a silhueta renal esquerda alongada, com presença de duas pelves. O rim direito não foi encontrado. Solicitou-se exame de urografia excretora para avaliação de ureteres. O diagnóstico foi de ectopia renal cruzada com fusão em um felino assintomático e sem alterações na função renal.(AU)

Urorresonancia en 3 Tesla, técnica, aplicaciones clínicas / Magnetic Resonance Urography (MRU) at 3 Tesla, Technique, Clinical Applications

Introducción: La ausencia de radiación ionizante y de medios de contraste yodados son las ventajas más grandes de la urografía por resonancia magnética (uroRM) frente a la urografía por escanografía (uroTAC). Objetivo: Informar la utilidad de la uroRM, sus ventajas y limitaciones mediante diferentes casos, así como las características imaginológicas propias de este estudio en el magneto de 3 Tesla (3T). Métodos: Se inició una recolección de los casos de uroRM desde agosto de 2013 hasta julio de 2014, realizados en resonador de 3T. Conclusiones: La uroRM en 3T proporciona una excelente definición del sistema urinario y permite establecer las etiologías de patología obstructiva y otras lesiones renales.

Introduction: The absence of ionizing radiation and iodinated contrast media are the biggest advantages of magnetic resonance urography (UroRM) against urography scans (UroCT). Objective: Inform the utility of UroRM, its advantages and limitations through different cases and imaging characteristics typical of this study in the 3 Tesla magneto (3T). Methods: A collection of cases of UroRM was started from August 2013 to July 2014, conducted in 3T resonator. Conclusions: 3T UroRM provides an excellent definition of the urinary system and allows for the etiologies of obstructive disease and other renal lesions.

Sensibilidad y especificidad de ecografía renal versus urografía excretora para el diagnóstico de litiasis renal / Sensitivity and specificity of renal ultrasoundversus excretory urography in thediagnosis of renal calculi

Con el objetivo de comparar la Sensibilidad y Especificidad Diagnostica de la Ecografía renal versus la Urografía excretora en el diagnóstico de Litiasis Renal en el hospital EsSalud Ica en 2011, se realizó un estudio de tipo prueba diagnóstica en dos grupos, el primero formado por 256 pacientes que se realizaron ecografía renal, y el segundo grupo por 56 pacientes quienes se realizaron urografía excretoria, ambos grupos tienen como patrón de oro a la tomografía abdomino pélvica sin contraste, encontramos que la ecografía presento una sensibilidad 76% IC (63.16%- 88.84%.), una especificidad del 76.47%, IC(70,40%-82.54%), mientras que la urografía excretoria presento una sensibilidad 66.67% IC (39,48%- 93.86%), una especificidad del 87.80%, IC (76.57%-99.04%), finalmente concluimos que la ecografía es más sensible pero menos específica que la urografía excretoria lo que sería factible utilizar la ecografía renal como primera línea de ayuda diagnostica para litiasis renal. (AU)

In order to identify the epidemiological characteristics of infants less than 1500 g (V LBW) admitted to the neonatal ward of Hospital Regional de lea, a retrospective, descriptive, observational developed on a population of 1722 newborns, finding an incidence of 30 VLBW (1.7%), of whom 73.3% were male, the mean gestational age was 32 weeks, the average weight was 1085g, 93.3% of mothers had a control inadequate prenatal, 3.3% received antenatal corticosteroids and 56.6% were products of the first pregnancy, plus 56.6% mortality was found, being the most common causes: prematurity, neonatal sepsis and surfactant deficiency disease. (AU)

Bilateral extraluminal ectopic ureters in a Maine Coon cat / Ureter ectópico extraluminal bilateral em um felino da raça Maine Coon

Ectopic ureters are rarely observed in cats. Therefore, for a better chance of success in the corrective surgical procedure and survival of the patient, diagnosis should be confirmed early. This report illustrates the occurrence of bilateral ectopic ureters in a seven month old Maine Coon cat and describes the medical and surgical management adopted for correction of the abnormality.

A ectopia dos ureteres é raramente observada em gatos. Assim, para aumentar as chances de sucesso do procedimento cirúrgico corretivo e promover a sobrevivência, o diagnóstico deve ser firmado precocemente. O relato em tela ilustra a ocorrência de ureter ectópico bilateral em uma gata Maine Coon, de sete meses, e descrevem-se as manobras médico-cirúrgicas adotadas na correção dessa anormalidade.

Lipomatose pélvica: relato de caso e revisão da literatura / Pelvic lipomatosis: a case report and literature review

A lipomatose pélvica é uma doença rara, na qual se observa acúmulo de tecido adiposo na pelve causando compressão extrínseca da bexiga, reto e vasos sanguíneos. Neste estudo relatamos o caso de um paciente do sexo masculino, 48 anos de idade, que apresentou dores lombares e síndrome disúria-polaciúria. São descritos os achados na urografia excretora, tomografia computadorizada e ressonância magnética.

Pelvic lipomatosis is a rare disorder where fat tissue deposition is observed in spaces of the pelvic area, causing extrinsic compression of the bladder, rectum and blood vessels. In the present report, the authors describe the case of a 48-year-old male patient presenting low back pain, dysuria and pollakiuria. Findings at excretory urography, computed tomography and magnetic resonance imaging are described.

Valoración en un solo paso del potencial donante renal: Angiografía y urografía por RM con correlación quirúrgica / One-step MR angiography and urography in the evaluation of potential renal living donors.

Objetivos. Evaluar el rendimiento diagnóstico de la angiografía renal (ARM) y urografía (URM) por Resonancia Magnética (RM) en potenciales donantes de riñón mediante la correlación con hallazgos quirúrgicos. Materiales y Métodos. Se evaluaron 55 potenciales donantes mediante protocolo angiográfico y urográfico en múltiples fases en un resonador de 1,5 T. La ARM valoró la existencia de variantes anatómicas o alteraciones estructurales arteriales o venosas y la URM valoró el parénquima renal y el sistema colector en fases nefrográfica y excretora. Los resultados fueron comparados con hallazgos quirúrgicos. Resultados. La correlación se realizó en 42 donantes efectivos. En ellos, se observó una especificidad de la ARM del 94% y una exactitud diagnóstica del 93%. Se identificaron variantes anatómicas y alteración estructural arterial en el 29% de los pacientes. La valoración venosa y urográfica de la RM resultó concordante quirúrgicamente en todos los casos. Conclusión. Las imágenes de RM proveen un método seguro y eficaz para la valoración prequirúrgica renal de forma integral en potenciales donantes de riñón.

Objectives. To evaluate diagnostic accuracy of renal MRangiography(MRA) and MR- urography (MRU) in the assessment of normal anatomy and renal vascular pathology in potential renal living donors compared with surgical findings. Materials and Methods. Evaluation of 55 potential living donors performing one-step MR angiography and MR urography in a 1.5 T magnet. MRA evaluated the presence of anatomic variants or arterial or venous pathologic conditions. MRU depicted renal parenchyma anatomy and collector system. These results were compared with surgical findings. Results. MRA and MRU findings were actually compared with surgical findings in 42 effective donors. MRA specificity was 94 % and diagnostic accuracy was 93 %. Anatomic variants and arterial structural abnormalities were detected in 29 % of patients. Venous and excretory surgical findings were consistent in 100 % of cases. Conclusion. One-step MRA and MRU constitutes an accurate method for pre-operative assessment of renovascular and excretory anatomy in potential living donors.

Radiographic diagnosis of traumatic urethrorectal fistula in dog / Diagnóstico radiográfico de fístula uretroretal traumática em cão

A dog with abdominal trauma had an urethrorectal fistula and secundary bilateral hidronephrosis and hydroureter, identified by urethrocistography and excretory urography. According to our researches, only two cases of traumatic urethrorectal fistula had been reported until now in veterinary medicine.

Um cão com trauma abdominal desenvolveu fístula uretroretal, hidronefrose e hidroureter bilaterais secundários, identificados por uretrocistografia e urografia excretora. Na literatura veterinária, há somente dois casos de fístulas uretroretais traumáticas descritos até o momento.

Alterações do trato urinário em urografias excretoras realizadas no Hospital Nossa Senhora da Conceição, Tubarão- SC, de setembro de 2004 à dezembro de 2005 / Urinary tract changes found in intravenous urography examinations in the Hospital Nossa Senhora da Conceição, Tubarão- SC, from september 2004 to december 2005

Objetivo: Avaliar 235 laudos de urografia excretora, descrevendo as principais alterações relacionadas com o trato urinário, testar a associação entre as alterações encontradas segundo sexo e faixa etária e discutir a utilidade do método radiológico de imagem. Métodos: Estudo transversal, descritivo realizado a partir de levantamento de 235 laudos de urografia excretora realizados no período de 14/09/2004 à 21/12/2005, no Serviço de Radiologia do Hospital Nossa Senhora da Conceição, Tubarão - SC. Resultados: Do total de 235 exames, 127 (54,04%) apresentaram alterações radiológicas, 93 (39,57%) foram normais e 15 (6,38%) foram excluídos por falha técnica, por serem inconclusivos, por ter idade inferior a 18 anos ou pelo exame não corresponder ao proposto pela avaliação do estudo. A alteração mais frequente foi a de litíase (76,3%), seguida da dilatação do sistema pielocalicial (26,8%). Observamos que 60 exames (47,24%) eram pacientes do sexo masculino e 67 (52,75%), do sexo feminino. A média de idade do estudo foi de 42,19 anos e a faixa etária que apresentou maior número de alterações foi a de idosos (70,58%), seguido do grupo de adultos (56,54%) e adultos jovens (44,44%). Conclusão: Com relação ao sexo, a única alteração com relevância estatística, foi a Estenose de JUP - presente, em sua totalidade, no sexo feminino - porém, com relação às faixas etárias estudadas, não foi observado nenhum achado radiológico com significância estatística. Apesar do advento de novas técnicas diagnósticas de imagem como o ultra-som, a tomografia computadorizada e a ressonância magnética, a urografia excretora continua tendo importante papel diagnóstico.

Background: To evaluate 235 reports of intravenous urography, analyzing the main alterations related with urinary tract, to test the association between the joined alterations according to sex and age, and to discuss the utility of the radiological method of image. Materials and Methods: Descriptive cross-sectional study based on data of 235 intravenous urography reports which was made between the period from September 2004 to December 2005, at the Radiological Service of Hospital Nossa Senhora da Conceição, Tubarão - SC. RESULTS: Of all the 235 exams, 127 (%) had presented radiologic alterations, 93 (%) were normal and 15(%) had been excluded by imperfection technique, for being inconclusive, being age lower than 18 years or for the exam not to correspond to the considered for evaluation of the study. The alteration most frequent was lithiasis (76,3%), followed by dilatation of the calyceal system (26,8%). It was observed that 60 exams (47,24%) were of the masculine sex e 67 (52,75%), of the feminine sex. The average age of the patients was 42,19 years and the age group which presented greater number of alterations was of aged (70,58%), followed by the group of adults (56,54%) and young adults (44,44%). Conclusions: With regard to the sex, the only alteration with relevance statistics, was stenosis of uretero-pelvic junction - present in its totality in the feminine sex - however, with regard to the studied ages, no radiological finding with statistic significance was found. Although the advent of new diagnostic techniques of image as the ultrasound, the computerized cat scan and the magnetic resonance, intravenous urography continues having important diagnostic paper.

Pielonefritis en ectopia renal cruzada y fusionada: Presentación de caso / Pyelonephritis in crossed and fusioned renal ectopy: Presentation of a case

La infección urinaria es no sólo la infección bacteriana más frecuente, sino la enfermedad más común del riñón y de las vías urinarias en la edad pediátrica, y un marcador o signo de anormalidades anatómicas o funcionales subyacentes. Se presenta un paciente al cual se le diagnosticó infección del tractus urinario, asociado a ectopia renal cruzada y fusionada con divertículo vesical, en el Hospital Provincial Pediátrico Docente Eliseo Noel Caamaño, de Matanzas, durante el mes de enero de 2009. Describimos la forma de presentación, así como los aspectos clínicos y estudios imagenológicos realizados de manara secuencial, que permitieron llegar al diagnóstico de esta entidad, teniendo en cuenta lo infrecuente que es, y que no se conoce su prevalencia con exactitud.

The urinary infection is not only the most frequent bacterial infection, but also the most common disease of the kidneys and the urinary tract in the pediatric age, and a marker or sign of underlying anatomic or functional abnormalities. We present a patient with a diagnosed infection of the urinary tract, associated to a crossed and fusioned renal ectopy with vesical diverticulum, treated in the Teaching Provincial Pediatric Hospital Eliseo Noel Caamaño, of Matanzas, on January 2009. We describe the presentation form, and also the clinical aspects and the imagenologic studies made in a sequential form that allowed us to arrive to the diagnosis of this entity, taking into account its infrequency and that its prevalence is not exactly known.

Uro - resonancia en niños / Uro - resonance in children

Ultrasound and nuclear medicine appear to be the modalities of choice when dealing with the imaging study of the urinary system in infants. In children, a CT sean does not have the impact it has had on adults, since pediatric patients present with different pathologies and also because of the peculiar physiological conditions of childhood. The Uro-resonance has emerged as a powerful and useful diagnostic tool, bringing together in a single study anatomical images and functional information as well without the use of ionizing radiation. We review the technical aspeets, anatomical and physiological concepts of the study, while providing examples of current applications in the infant.

El estudio por imágenes del sistema urinario del niño ha estado a cargo del ultrasonido y la medicina nuclear. En el niño, la tomografía computada no tiene el impacto que ha tenido en adultos, por tratarse de patologías diferentes y por las condiciones fisiológicas propias de la edad pediátrica. La Uro-resonancia se proyecta como una herramienta útil, reuniendo en un solo estudio imágenes anatómicas e información funcional, en ausencia de radiación ionizante. Se revisan aspectos de la técnica, conceptos anatómicos y fisiológicos del estudio, adicionando ejemplos de aplicaciones en el niño.

Ureter retrocava: relato de caso / Retrocaval ureter: a case report

Relata-se o caso de um paciente com ureter retrocava, diagnosticado inicialmente em exame de urografia excretora e confirmado com tomografia computadorizada do abdome. A tomografia computadorizada torna-se necessária não apenas para confirmar a posição do ureter em relação à veiacava inferior, como também para excluir outras doenças que cursam com hidronefrose, pois hidronefrose é o principal achado do ureter retrocava sintomático.

The authors report a case of a patient with retrocaval ureter found out in an excretory urography and confirmed with abdominal computerized tomography. The computerized tomography is necessary to confirm the position of the ureter and to exclude other diseaseswhich are associated with hydronefrosis, the main imaging finding,when there is a symptomatic retrocaval ureter.

Trauma renal, a propósito de un caso / Renal trauma, case report

Se presenta el caso de una paciente de 9 años de edad con antecedente de trauma renal grado IV, a la que tubo que realizarse nefrectomía. La conducta quirúrgica se determino por los hallazgos de exámenes complementarios como la urografía endovenosa. Actualmente se considera que el tratamiento conservador es una opción en la mayoría de los paciente con trauma renal, existiendo pocas indicaciones para una conducta quirúrgica en este tipo de pacientes. Es de vital importancia la adecuada interpretación de los exámenes complementarios para determinar una conducta. Se aprovecha el caso clínico para realizar una revisión de la literatura.

The case of a patient of 9 years of age with antecedent of renal trauma appears degree IV, to which to be made nefrectomy. The conduct I determine myself by the complementary findings of examines like urografhy. At the moment it is considered that the preservative treatment is an option in mayor of the patient with renal trauma, existing few indications for a quirurgica conduct in this type of patients. It is of vital importance the suitable interpretation of examination complementary to determine a conduct.