Urogenital ImagingDuplication, ureteric
the presence of two ipsilateral ureters, believed to be the result of premature branching of the ureteric bud during prenatal development. Ureteric duplication may be complete (see
double ureter) or partial. Partial ureteric duplication results in a Y-shaped
ureter, with a bifid pelvicaliceal system. The incidence of partial ureteric duplication is estimated at 1 in 100. In most cases, partial duplication is an asymptomatic anomaly. However, disorders of peristalsis may occur in one segment of the duplication. This results in the passage of urine from one limb of the duplication to the other (
yo yo peristalsis ureteric), which has been implicated in the development of urinary tract infections.
Partial ureteric duplication is clearly demonstrated by intravenous urography (Fig.1). On ultrasound, partial duplication may be indirectly suggested by recognition of two distinct groups of renal sinus echoes (the "split sinus" sign), although this finding is not always present. On CT or MRI, duplication is suggested when axial images of the central kidney do not contain collecting system elements or renal sinus fat ("faceless" kidney sign). More inferiorly, two adjacent ureters may be recognized on axial CT images, particularly after administration and excretion of intravenous contrast. In partial duplication, only one ureter is identified at the insertion of the distal ureter into the bladder.
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Intravenous urogram showing duplication of the left ureter.
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Duplication, ureteric, Fig.1 | |