Archives of the AFIP -- RadioGraphics 1995; 15: 653-669

Figure 15: Segmental multicystic dysplasia of the upper pole moiety of a duplicated renal collecting system, occurring in a 5-year-old girl with recurrent urinary tract infection. Panel A Transverse oblique sonogram of the left kidney shows a cluster of cystic loculi in the upper pole (arrows), adjacent to normal renal parenchyma. Panel B Tc-99m DMSA scan demonstrates a large defect (arrows) corresponding to the upper pole of the left kidney. Panel C Anteroposterior early filling digital spot image from a voiding cystourethrographic study, performed with a non-balloon catheter, shows a round filling defect at the base of the left side of the bladder (arrow). Panel D On the voiding phase image, the bladder is fully distended and the filling defect is obscured. Left vesicoureteral reflux permits visualization of bowing and inferior displacement of the lower pole moiety collecting system, the "drooping lily" sign. Panel E Intraoperative photograph of the bladder base mucosa shows the ectopic ureterocele (arrow). A Foley catheter is in place (arrowhead). Panel F Intraoperative photograph of the exposed left kidney prior to upper pole nephrectomy shows the cystic dysplastic upper pole moiety.

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