Hadi Sasani1, Mazhar Özkan2, Nergiz Ekmen3

1Department of Radiology, Tekirdağ Namık Kemal University, Faculty of Medicine, Tekirdağ, Türkiye
2Department of Anatomy, Tekirdağ Namık Kemal University, Faculty of Medicine, Tekirdağ, Türkiye
3Department of Gastroenterology, Gazi University, Faculty of Medicine, Ankara, Türkiye

Keywords: Calculi, computed tomography, fused kidney, orientation.


Objectives: We aimed to evaluate the morphometric properties of horseshoe kidneys (HSKs) detected in computed tomography.

Materials and methods: Between April 2017 and September 2020, A total of 48 patients (30 males, 18 females; mean age: 48.1±19.1 years; range 4 to 92 years) with HSK variation and 20 healthy individuals (9 males, 11 females; mean age: 38.3±23.3 years; range, 4 to 73 years) were included in the study. The thickness, length, location, midline shift of the isthmus and its distance to the diaphragm; the fusion tilt angle, and its orientation were evaluated. The renal pelvis angles (RPA) and the midline orientations; the pole-to-pole angle (PPA), degrees of hydronephrosis, and the presence of stones were assessed.

Results: Anteromedial orientation was the most common orientation, and the isthmus was mostly located at L3-L4 (31%) level. Isthmus thickness was 15.7±4.9 mm, width was 37.8±11.9 mm. The mean total calculus volume was 3.14 mm3 and the total calculus density was 543.87 HU. No correlation was found between RPA and calculus (p>0.05). The right PPA was 27.2±6.4 degrees, left PPA was 22.6±7.6 degrees. There was a statistically significant difference between between right and left renal pelvis midline angles, right and left renal pelvis horizontal angles, right pole-pole midline angle, and bilateral renal pelvis diameters (p<0.0001).

Conclusion: Horseshoe kidneys are usually asymptomatic. However, other pathologies such as calculus and hydronephrosis may accompany it. In this study, although there were significant differences in morphological parameters in the HSK group compared to the control group, no statistically significant correlation was found between calculus volume and RPA.

Cite this article as: Sasani H, Özkan M, Ekmen N. Retrospective morphometric analysis of patients with horseshoe kidney variation in computed tomography imaging. D J Tx Sci 2022;7(1-2):1-6.

Ethics Committee Approval

Approval of the Chief Physician of Tekirda¤ Namık Kemal University Hospital has been obtained (date: 31.12.2020). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Conceptualization, data curation, methodology, formal analysis, writing-original draft, writing-review & editing: H.S.; Formal analysis, critical review & editing: M.Ö., N.E.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/ or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.