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  Indian J Med Microbiol
 

Figure 2: MR Urography -T2 weighted images showing duplicated collecting system of the left kidney. The left upper moiety (LUM) showed normal pelvi-calyceal system and ureter. The lower moiety was grossly hydronephrotic showing thinned out renal parenchyma and markedly dilated and tortuous ureter (LU) till the lower end. The right kidney (RK) showed marked hydronephrosis with reduced parenchymal thickness (4.7mm) and dilated, tortuous right ureter (RU) till lower end. The right ureter showed kinking in its path with external compression by dilated left ureter at lower end. The Urinary bladder (UB) was normally distended and indented on the superior surface by the dilated left ureter. So MR urography confirmed left duplex system and showed grossly dilated left ureter as the cause of palpable abdominal mass. It also showed that the hydronephrosis in right kidney was most likely due to tortuosity of right ureter and pressure of dilated left ureter on the lower third of right ureter

Figure 2: MR Urography -T2 weighted images showing duplicated collecting system of the left kidney. The left upper moiety (LUM) showed normal pelvi-calyceal system and ureter. The lower moiety was grossly hydronephrotic showing thinned out renal parenchyma and markedly dilated and tortuous ureter (LU) till the lower end. The right kidney (RK) showed marked hydronephrosis with reduced parenchymal thickness (4.7mm) and dilated, tortuous right ureter (RU) till lower end. The right ureter showed kinking in its path with external compression by dilated left ureter at lower end. The Urinary bladder (UB) was normally distended and indented on the superior surface by the dilated left ureter. So MR urography confirmed left duplex system and showed grossly dilated left ureter as the cause of palpable abdominal mass. It also showed that the hydronephrosis in right kidney was most likely due to tortuosity of right ureter and pressure of dilated left ureter on the lower third of right ureter