B5-079 Renal Imaging Flashcards
- cheap and quick
- poor soft tissue detail and radiation
conventional radiographs
- high spatial resolution, relatively short exam
- high radiation dose, risks of contrast
CT scans
- provides functional data
- poor resolution, radiation
nuclear scintigraphy
- relatively cheap and quick, no radiation
- can’t visualize the ureters, operator dependent
US
- high spatial resolution, no radiation
- high cost, long procedure, prone to artifact
last choice
MRI
non-contrast CT is very good at looking for
renal stones
the corticomedullary phase and nephrographic phase are good for evaluating
CT
solid or cystic masses
renal carcinoma vs. simple cyst
the pyelographic phase is good for evaluating
CT
renal pelvis and ureter for mass lesions
urothelial carcinoma
the further a structure is from the US transducer, the […] it takes for the sound beam to travel
longer
most common renal scintigraphic study is
MAG-3
good for evaluating renal function in CKD
nuclear scintigraphy
appropriate intial imaging for microhematuria
CTU with and without contrast
kidney stones
RCC
most common subtype of RCC?
clear cell
large irregularly enhancing mass arising from superior pole of the kidney
clear cell RCC
risk factors for RCC
smoking, obesity
arises from PCT
RCC
classic RCC triad
- flank pain
- hematuria
- flank mass
only [..]% of patients present with the RCC triad
10
a majority of RCC are found
incidentally
where does RCC invade
2
ipsilateral renal vein and adrenal gland
non contrast CT is very sensitive for
calculi
best initial imaging modality for the evaluation of hematuria
CT
sensitive for mass lesions in renal parenchyma
contrast CT
does a patient with pyelonephritis need imaging?
not usually
who should receive imaging for suspected pyelonephritis?
diabetics
immunocompromised
best imaging modality for renal abscesses
CT
best imaging modality for decreased perfusion in affected segments of kidney in pyelo
CT
- wedge shaped or round areas of poor enhancement in parenchyma
- “striated nephrogram”
pyelonephritis
wedge shaped diminshed perfusion
pyelonephritis
pyelonephritis
mixed solid/cystic enhancing lesion
RCC
RCC has a heterogenous apperance due to
necrosis and hemorrhage
[…] adds little value to the management of patients with pyelonephritis who improve within 72 hrs
imaging
decreased perfusion of renal pyramids
pyelonephritis
[…] images allow for the detection of renal calcifications
pre-contrast images
[…] images help to detect and characterize solid vs cystic cortical masses
post-contrast
[…] helps to evaluate the renal pelvis and ureter for mass lesions
delayed imaging
