Horseshoe kidney (HSK) is the most common renal fusion, which is characterized by three anatomic anomalies: ectopia, malrotation and vascular changes. Patients with HSK are prone to a variety of complications, genitourinary and non-genitourinary. In this paper, the anatomy of HSK is delineated with a great emphasis on its blood supply. After reviewing the literature, the arterial supply patterns found by each author were categorized according to the classification system proposed by Graves. The majority of HSKs were found to be supplied by renal arteries derived from the abdominal aorta below the isthmus or by vessels originating from the common iliac arteries. In addition, the abnormalities associated with HSK are highlighted and classified in anatomical variations, congenital anomalies as well as in pathologic conditions related to HSK.

Horseshoe kidney: a review of anatomy and pathology

Because the incidence of colonic diverticulosis is high in the general population, incidental asymptomatic diverticulosis is commonly seen on radiology imaging studies. However, diagnostic imaging performed specifically for diverticular disease is essentially limited to imaging of suspected acute colonic diverticulitis (ACD) and its complications. The clinical diagnosis of ACD can be challenging, and imaging has become an essential tool to aid in diagnosis, assess severity of disease, and aid in treatment planning. Computed tomography (CT) has replaced contrast enema as the imaging procedure of choice for diverticulitis. Ultrasound has also been successfully used for diagnosis, and magnetic resonance imaging (MRI) has significant potential as a radiation-free imaging test for acute colonic diverticulitis.

Imaging Update: Acute Colonic Diverticulitis

Purpose
The purpose of this study was to prospectively investigate patients with suspected acute colonic diverticulitis and to provide sensitivity, specificity, and interobserver agreement in a blinded trial.

Prospective Evaluation of the Value of Magnetic Resonance Imaging in Suspected Acute Sigmoid Diverticulitis

OBJECTIVE. The purpose of this study was to identify the CT features of mucocele of the appendix coexisting with acute appendicitis and to determine whether this entity can be differentiated from acute appendicitis without mucocele.MATERIALS AND METHODS. CT scans of 70 patients (12 with acute appendicitis with mucocele, 29 with acute appendicitis without mucocele, 29 with a normal appendix) were retrospectively interpreted by two readers. The appendix was evaluated for maximal luminal diameter, cystic dilatation, luminal attenuation, appendicolith, mural calcification and enhancement, periappendiceal fat stranding, fluid, and lymphadenopathy. CT findings were compared by use of Mann-Whitney U and Fisher's exact tests. Receiver operating characteristics analysis was performed to assess the diagnostic utility of appendiceal luminal diameter in differentiating acute appendicitis with from that without coexisting mucocele.RESULTS. Cystic dilatation of the appendix and maximal luminal diameter achieved statist...

https://www.ajronline.org/doi/pdfplus/10.2214/AJR.08.1572

CT Diagnosis of Mucocele of the Appendix in Patients with Acute Appendicitis

Congenital abnormalities of the kidney and urinary tract (CAKUT) include a wide range of abnormalities ranging from asymptomatic ectopic kidneys to life threatening renal agenesis (bilateral). Many of them are detected in the antenatal or immediate postnatal with a significant proportion identified in the adult population with varying degree of severity. CAKUT can be classified on embryological basis in to abnormalities in the renal parenchymal development, aberrant embryonic migration and abnormalities of the collecting system. Renal parenchymal abnormalities include multi cystic dysplastic kidneys, renal hypoplasia, number (agenesis or supernumerary), shape and cystic renal diseases. Aberrant embryonic migration encompasses abnormal location and fusion anomalies. Collecting system abnormalities include duplex kidneys and Pelvi ureteric junction obstruction. Ultrasonography (US) is typically the first imaging performed as it is easily available, non-invasive and radiation free used both antenatally and postnatally. Computed tomography (CT) and magnetic resonance imaging (MRI) are useful to confirm the ultrasound detected abnormality, detection of complex malformations, demonstration of collecting system and vascular anatomy and more importantly for early detection of complications like renal calculi, infection and malignancies. As CAKUT are one of the leading causes of end stage renal disease, it is important for the radiologists to be familiar with the varying imaging appearances of CAKUT on US, CT and MRI, thereby helping in prompt diagnosis and optimal management.

Multi-modality imaging review of congenital abnormalities of kidney and upper urinary tract

Horseshoe kidney is the most common renal fusion anomaly and the patients are prone to a variety of complications, such as stone disease, pelviureteric junction (PUJ) obstruction, trauma, infections and tumours. As result of the abnormal anatomy of a horseshoe kidney, imaging and treatment pathways vary substantially from the normal kidney. In this review, we describe the role of modern imaging in depicting horseshoe kidneys and their complications, in tandem with the role the interventional radiologist plays in treating these patients.

Imaging of horseshoe kidneys and their complications.

Magnetic resonance imaging (MRI) is rapidly emerging as a useful imaging modality for the evaluation of the gastrointestinal tract. Increasingly rapid sequences and improving hardware have significantly improved the visualisation of diseases of the colon. MRI has a major advantage over CT in that there is no ionising radiation. In our institution, MRI has increasingly been used as a complimentary imaging modality to CT in the diagnosis and evaluation of diverticulitis and its complications. In this review article, we illustrate the emerging role of MRI in the diagnosis and evaluation of colonic diverticulitis.

Pictorial review: magnetic resonance imaging of colonic diverticulitis.

Giant Mucinous Cystadenoma of the Appendix

Objective To determine the value of the kidneys, ureters, and bladder radiograph (KUB) in the diagnosis of urolithiasis using unenhanced helical computerized tomography (UHCT) as the gold standard. Methods A retrospective study was performed on 100 consecutive patients being investigated for suspected urolithiasis. All patients presented with acute renal colic and had a KUB and UHCT within a 3-hour period. UHCT and KUB pairs were assessed separately by 2 radiologists in consensus who were blinded to the clinical details of the patients and the results of the other tests and examinations. The presence, location, number, and size of stones were recorded. Each UHCT and KUB pair was then compared for concordance on a stone-by-stone basis. Results KUB was concordant with the gold standard UHCT in only 50% of patients (11 positive, 39 negative), giving a sensitivity of 18.6%, a specificity of 95.1%, a positive predictive value of 84.6%, and a negative predictive value of 44.8%. Conclusion KUB has a very low sensitivity for the detection of urolithiasis, although specificity is acceptable.

Urolithiasis: how accurate are plain radiographs?

Our study has shown that ultrasound-guided localisation and removal of Implanon™ rods is safe, practical and highly successful. Over a 4-year period, 119 patients had successful, uncomplicated removal of their subdermal devices.The technique is particularly useful for removal of the device when it is not palpable or when an attempt at removal of a palpable device has not been successful.

Ultrasound-guided removal of Implanon devices.

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