Purpose or Case Report: Duplicated collecting systems can be associated with vesicoureteral reflux, urinary obstruction, ureteroceles, incontinence, and renal parenchymal scarring which can result in decreased renal function, therefore, early identification by radiologists and clinicians is crucial. The purpose of this educational exhibit is to review the embryology, highlight the imaging manifestations, and discuss the clinical ramifications of duplicated renal collecting systems in the pediatric population.
Methods & Materials: Imaging studies performed in the evaluation of patients with renal collecting system duplication at our institution were retrospectively reviewed. Representative images were selected to depict the varied appearances of duplicated urinary tract anomalies as seen by ultrasonography, voiding cystourethrography (VCUG), computed tomography, Dimercaptosuccinic acid (DMSA) renal cortical scintigraphy, and magnetic resonance urography (MRU).
Results: 1. Basic embryologic development of the urinary tract was reviewed to contextualize the spectrum of duplicated urinary tracts.
2. The salient imaging features of duplicated urinary tract collecting systems and associated anomalies were illustrated by each imaging modality with special attention to subtle diagnostic clues and potential pitfalls.
3. The potential complications and clinical management of patients with duplicated urinary tracts were discussed to provide perspective and guidance in regards to radiologic interpretation and reporting.
Conclusions: By understanding the embryology, varied radiologic appearances, and clinical persepctives, the radiologist can promptly recognize duplication anomalies of the pediatric urinary tract and the commonly associated complications.