1.12 Ultrasound examination of the kidney and the ureter, X-ray and isotopes Flashcards
US
- most common, simple, harmless
- 3.5 MHz transducer
- 5MHz used for testes, penis
- ALL urological organs EXCEPT : Ureters can be imaged, scrotal organs, urethra, penis
kidney US can reveal information about
- size
- location
- shape
- number of kidneys
pathologies diagnosed by renal US
- tumor
- cyst
- stone
- congenital disorder
- agenesis
- atrophy
- hydronephrosis
US gives NO information about kidneys —–
function !
but shrunken or congenital hypoplastic kidneys or thin parenchyma are most probably associated with diminished function
US of retroperitoneum can reveal
- masses
- blood or urine
- enlarged LNs
X-ray can reveal
- calcium containing stones
- foreign bodies
- bone metastasis
CT can image
- ALL urological tumors
- LN’s
- stones
- pyelonephritis
- abscess in kidney
- emergency cases
- congenital disease
without contrast CT can measure
density (HU) of stone
CT with contrast can give info about
function of kidneys by means of duration and intensity of excretion
retrograde pyelography can reveal the cause of
non-functioning kidney :
-hydronephrosis
-obstruction (stone, tumor, ureteral stricture)
retrograde pyelography can be performed with —-
cystoscope w/ tube inserted into ureter
tube is filled w/ contrast
anterograde pyelography
percutaneous nephrostomy inserted into kidney
>tube can fill calyceal system and ureter w/contrast
cystography - what is it
filling bladder with contrast
indication of cystography
suspicion of bladder
-peroforation
-rupture
isotope scintigraphy indication
- frequently used
99Tc scan indication
1. ALL cases of prostate cancer : to prove or exclude bone metastasis
2. selected cases in suspicion of bone metastasis in bladder or renal cancer
3. The best option to determine kidney function exactly and seperately
The best option to determine kidney function exactly and seperately
Tc99 isotope scintigraphy
DMSA (Dimercaptosuccinic acid scan )
- IV radioactive compound which concentrates in functioning/normal kidney tissues
It evaluate the amount of normal functioning tissue of your kidneys - it DOESNT provide info as to the internal structure of kiney
static image assessing renal morphology, structure and function.
DMSA DOESNT provide info about
it DOESNT provide info as to the internal structure of kiney
Technetium-99m DSMA (dimercapto succinic acid
MAG3 (mercaptoacetyl triglycine)
excreted by kidney almost exclusively by tubular secretion (less by filtration)
to determine if there’s dital obstruction and split renal function
MAG3 usually used for dynamic imaging to assess renal excretion
