Unidade de Pesquisa Urogenital, Universidade do Estado do Rio de Janeiro - UERJ, Rio de Janeiro, RJ, Brasil.
Int Braz J Urol. 2022 May-Jun;48(3):561-568. doi: 10.1590/S1677-5538.IBJU.2022.99.12.
To analyze the 3-dimensional intrarenal anatomy of horseshoe kidneys (HK) and kidney with complete ureteral duplication (CUD), in polyester resin endocasts of the collecting system and in patients submitted to 3D computerized tomography scan (CT-scan).
We analyzed seven 3-dimensional polyester resin endocasts of the kidney collecting system obtained from 6 fresh adult cadavers (4 with unilateral CUD and 2 with horseshoe kidney) and CT-scan reconstruction images of kidneys from 24 patients: 6 patients with HK, 8 with CUD and 10 patients without renal anomalies that were used as controls. We analyzed the spatial distribution of the calices, the infundibula diameters, the angle between the lower infundibulum and the renal pelvis (LIP) and the angle between the lower infundibulum and the inferior minor calyces (LIICA). Measurements of the width and length of the inferior infundibulum and the infundibula of the minor calyces, as well as the angles (LIP and LIICA) were made with the aid of the LibreOffice 6.3 software. The data were analyzed with the IBM® SPSS® Statistics.
There was no statistical difference in the inferior pole measurements between the groups with anomalies and the control group, both in polyester resin endocasts and CT-scan reconstruction images for LIP. When we compared the LIP in the CT-scan between HK versus CUD (p= 0.003), and HK versus the control group (p= 0.035), we observed statistical difference.
The knowledge of spatial anatomy of lower pole is of utmost importance during endourologic procedures in patients with kidney anomalies. In the present study we observed that horseshoe kidneys had more restrictive anatomic factors in lower pole than the complete ureteral duplication.
分析马蹄肾（HK）和完全输尿管重复（CUD）患者肾盂系统聚酯树脂内铸型和 3D 计算机断层扫描（CT 扫描）的三维肾内解剖结构。
我们分析了 6 具成人尸体（4 具单侧 CUD 和 2 具马蹄肾）的 7 个 3D 聚酯树脂肾收集系统内铸型和 24 例患者的 CT 扫描重建图像，包括 6 例 HK、8 例 CUD 和 10 例无肾脏异常的患者作为对照组。我们分析了肾盏的空间分布、漏斗直径、下漏斗与肾盂（LIP）之间的角度和下漏斗与下小肾盏（LIICA）之间的角度。借助 LibreOffice 6.3 软件测量下漏斗和小肾盏漏斗的宽度和长度以及角度（LIP 和 LIICA）。数据使用 IBM® SPSS® Statistics 进行分析。
在聚酯树脂内铸型和 CT 扫描重建图像中，异常组和对照组的下极测量值在 LIP 方面无统计学差异。当我们比较 HK 与 CUD（p=0.003）和 HK 与对照组（p=0.035）之间的 CT 扫描 LIP 时，我们观察到统计学差异。
在有肾脏异常的患者进行腔内泌尿外科手术时，了解下极的空间解剖结构非常重要。在本研究中，我们观察到马蹄肾的下极解剖结构比完全输尿管重复更具限制性。
