Computed tomography angiography with 3D reconstruction in diagnosis of hydronephrosis cause by aberrant renal vessel: A case report and mini review

BACKGROUND: Congenital hydronephrosis is often caused by aberrant renal vessel and it is difficult to be diagnosed and treated at the early stage due to lack of the significant symptoms. Although current medical diagnosis tools are widely used, the aberrant renal vessel cannot be displayed very well in the images. OBJECTIVE: To investigate whether applying computed tomography (CT) angiography with 3D reconstruction can improve efficacy in diagnose of this congenital hydronephrosis. MATERIALS AND METHODS: A male patient of 18 years old was diagnosed as hydronephrosis of left kidney. A CT angiography with 3D reconstruction was evaluated in diagnosis of the prenatal hydronephrosis compared to ultrasound (US) and intravenous urogram (IVU). RESULTS: US and IVU images were able to display the dilation of left pelvic and the dilated calyces, and the thinner of renal parenchyma on the left kidney (Grade II-IV), but failed to detect the causing of hydro-nephrosis. CT angiography with 3D reconstruction provided accurate images of the dilated renal pelvic, upper segment of the ureter, and an aberrant vessel bundle overcrossing at the left renal pelvic-ureter junction as well. The aberrant vessel could be revealed during surgery. CONCLUSIONS: A CT angiography with 3D reconstruction provides a more accurate diagnostic approach for the congenital hydronephrosis caused by aberrant renal vessel. Thus, it can offer surgeons very important information in the pre-surgery planning.