CT findings of the main pathological conditions associated with horseshoe kidneys

Abstract

Horseshoe kidney (HSK) is the most common renal fusion anomaly, with a prevalence of 0.25% among the general population. It consists of kidney fusion across the midline. HSK can be present as an isolated condition in 30%, but there is a wide variety of associated abnormalities. The most frequent include ureteropelvic obstruction, lithiasis and infections. There is also a higher risk of kidney lesions in trauma and an increased incidence of malignancies. Awareness of embryology and anatomy is essential to assess and understand the complications affecting HSK. CT is an excellent method for identification of its main findings.Horseshoe kidney (HSK) represents one of the most frequent renal malformations, with an incidence of 0.25% among the general population, being twice as frequent in males.1-3 It consists of a fusion of the kidneys across the midline, joined by an isthmus of renal parenchyma or fibrous tissue. 1,3 There are no known genetic determinant factors, although it has been described on identical twins and siblings of the same family. 4CT TECHNIQUE Multislice CT allows obtaining images with high spatial and temporal resolution over multiple planes and threedimensional reconstructions of high quality, and therefore the technique of choice for evaluation of urinary tract anatomy and pathologies associated with HSK.

Primary desmoplastic small-round-cell tumor of the ovary

“…Also, the radiation oncologist should have a good radiotherapy field planning to avoid radiation nephritis as most of the renal parenchyma overlies the para-aortic lymph nodes. In the abovementioned case, the patient was presented by bilateral ovarian masses, a finding that usually first directs the oncologist's attention to the possibility of either Krukenberg tumor or primary ovarian cancer [17]. Indeed, this case was handled as such and it was only the final pathology that revealed the diagnosis of this rare tumor.…”

Rim Em Ferradura Em Paciente Com Doença Renal Policística: Relato De Caso

“…A maioria dos pacientes é assintomática, sendo que nos pacientes com rim em ferradura, a porcentagem de sintomáticos é de 25-30%, sendo necessário tratamento. A cirurgia pode ser o tratamento quando há complicações importantes como os cálculos renais, infecções, tumores ou obstruções (9,11,13) . O paciente do caso relatado recebeu antibioticoterapia no manejo da pielonefrite aguda, com o quadro clínico evoluindo favoravelmente e recebendo alta hospitalar, sendo orientado a manter antibióticos e sintomáticos domiciliares e a prosseguir com o acompanhamento ambulatorial nefrológico e urológico.…”

“…Trata-se de uma alteração assintomática na maioria das vezes, podendo, no entanto, cursar com nefrolitíase, estenose de junção ureteropélvica, hipertensão renovascular e infecções urinárias (6) . Há também um aumento da chance de lesão renal em traumas abdominais e uma maior incidência de doenças renais malignas (11) . O diagnóstico é muitas vezes incidental, podendo ser realizado tanto por tomografia computadorizada (TC) quanto por ressonância magnética.…”

Hilar Arteriovenous Pattern in a Case of Horseshoe Kidney

“…Due to this fact, they do not rotate 90°anteriorly, which damages the arteriovenous formation, giving rise to numerous accessory vessels. [2][3][4] This malformation has a prevalence of 0.25% (1 in 400 births) and a higher rate in males (2:1 or 3:1). The arrangement of the arteries and veins in the renal hilum varies considerably, which can compress the ureters and cause urinary lithiasis in up to 41% of the cases.…”