Advances in upper urinary tract anatomy through imaging techniques

Abstract

This scoping review was conducted based on the Joanna Briggs Institute's theoretical framework and registered with the Open Science Framework (https://osf.io/b27wc). The study analyzed 29 manuscripts published between 2013 and 2023, focusing on imaging exams to synthesize evidence on the anatomy and clinical correlations of the upper urinary tract. The results revealed significant findings, highlighting the intrarenal pelvis as a possible predictive indicator of urinary loss after partial nephrectomy. This emphasizes the importance of anatomical assessment of the renal pelvis. Brödel's avascular plane has been categorized into three types relevant to pre-surgical patient planning. Multiple renal arteries and venous variations have also been reported, including retro-aortic and circum-aortic renal veins. A movable section related to the ureter was described in the perirenal space, delimited by the point of intersection with the gonadal vessels. The ureteropelvic and ureterovesical junctions were found to be anatomical points susceptible to ureteral constriction. On the other hand, the point at which the ureter crosses the iliac vessels is no longer considered a site prone to ureteral obstruction. The authors emphasize the need to adopt a standardized terminology to describe the anatomical variations of the blood vessels related to the kidney. Using diverse and unclear terms can hinder teaching and research in this area and lead to inaccuracies. From the authors' perspective, imaging exams have enhanced anatomical accuracy, benefiting the teaching of human anatomy and significantly contributing to continuous medical breakthroughs.

Keywords: Computed Tomography; Imaging Exam; Kidney; Magnetic resonance; Ultrasonography; Ureter.