Diagnostic imaging of the Urogenital tract Flashcards
What imaging can be used for urogenital tract?
- Radiography
- Contrast radiography
- Ultrasound
What is seen with normal uterus + ovaries on imaging?
- Not visible on radiographs
- US = body between bladder ventrally + descending colon dorsally
What is seen with pyometra on imaging?
- Radiography = dilated, soft tissue opacity loops originating between bladder + colon
-MASS effect - US = fluid dilation of the uterine horns + body
-thin/thick cystic wall
What is seen with a normal prostate on radiography?
- Caudal to bladder, may be within pelvic canal
- Symmetrical, ovoid to round, urethra centrally
- Homogenous soft tissue opacity
What can cause prostatomegaly?
- Benign prostatic hyperplasia - entire dogs, symmetrical enlargement, soft tissue opacity
- Prostatitis - entire, marked enlargement,
-regular / irregular shape, may see mineralisation +/- loss of serosal detail - Prostatic neoplasia - castrated, mineralisation, irregular shape +/- loss of serosal detail
What are prostatic neoplasias likely to be? Do they metastesise?
- Neutered dogs withs mineralisation = neoplasia
- Carcinoma, TCC
- Metastasis to medial iliac lymph nodes + lumbar vertebrae + Lungs
How would you perform cystography?
- Catheterise + empty bladder
- Instill with contrast medium until reasonably distended
What can be seen with double contrast cystography?
- Calculi = central defects in contrast pool
- Blood clots = may adhere to bladder wall, often irregular
- Air bubbles = iatrogenic, at pool margins
What is done with retrograde urethogram / vaginourethogram?
- Catheterise + empty bladder
- Inflate bladder w air/gas
- Place catheter tip in tip of penis / vulva + clamp
- Inject iodine based contrast + expose at end of injection
What is done with intravenous urography?
- IV iodine contrast to see transition through kidneys + ureters into bladder w multiple radiographs
- Need adequate renal function + hydration + fasting + enema
When would you use cystography, retrograde urethrogram, IV urogram?
- Cystography = bladder
- Retrograde urethrogram = Urethra (bladder)
- IV urogram = Ureters, Kidneys (refer for CT)
What is seen with normal bladder on imaging?
- Radiography = pear-shaped, smoothly marginated, soft-tissue opacity in caudoventral abdomen
- US = pear-shaped organ in caudal abdomen w anechoic content
What is seen on imaging with Cystitis (chronic)?
- Radiographs = not visible
- Double contrast cystography = thickened wall, irregular mucosa, blood clots
- US = irregular thickened wall, blood clots
What is seen with bladder calculi on imaging?
- Radiography = accumulate in most dependent part of bladder ( centrally)
-struvite, oxalate, calcium phosphate = marked visibility
-Silicate = moderate visibility
-Cystine + urate = non-opaque to faint visibility - US = strong distal shadowing
What dogs are urate seen in ?
- Dalmatians
- Young dogs with PSS
What is seen with bladder masses on imaging?
- Radiography = Not visible on plain radiography (effacement)
-Contrast = defect in contrast pool / soft tissue opacity on pneumocystogram - Predilection site = trigonium, dorsal bladder wall
- US = Urothelial cell carcinoma (TCC)
-Sessile, polypoid echoic mass
What is seen on imaging with bladder rupture?
- Radiographs = may see loss of serosal detail + small bladder
- Positive contrast = leakage of contrast
- US = Rarely see defect but will see free fluid
How would you assess urethra? lesions?
- Retrograde urethrogram
- calculi = defect in contrast medium
- mural lesion = narrowing of contrast medium
If you have stranguria what should you do?
- Retrograde urethrogram = problem usually in urethra
What is seen with the kidneys on imaging?
- Radiography = retroperitoneal space, L-kidney more caudal
-bean shaped, sharp + smooth margination - US = cortex = echoic, similar/ hypoechoic to liver
-medulla = near anechoic, least echogenicity of all organs
-renal pelvis + diverticula = hyperechoic, should not contain any urine (anechoic)
What can cause unilateral irregular renomegaly?
- Neoplasia
- Cysts
- Abscess, haematoma
What can cause bilateral irregular renomegaly?
- Neoplasia/metastasis
- PKD
- FIP
What can cause unilateral smooth (generalised) renomegaly?
- Neoplasia
- Hydronephrosis
- Perinephric pseudocyst
What can cause bilateral smooth (generalised) renomegaly?
- AKI
- Pyelonephritis
- Lymphoma
- FIP
What is seen with pyelectasia + hydronephrosis on US?
- Both show dilation of renal pelvis
- hydronephrosis - more severe dilation
What can cause microrenale (small kidneys)?
- CKD
- Dysplasia (congenital)
- Atrophy
What is seen with renal cysts on US?
- Renal cysts may be solitary as part of CKD - multiple = polycystic kidney disease
- Thin walled, may distort surface
- Persians predisposed
What is seen with ureters on imaging?
- Radiograph = not visible
- US = not visible
- IVU = v useful
