Diagnostic imaging - urogenital

Question 1

What organs of the urogenital tract can and cant you see?

Answer 1

Can see - kidneys, bladder
May see - prostate, uterus
Cant see - ureters, urethra, ovaries

Question 2

Where are kidney located on radiograph? Which is more cranial?

Answer 2

Cranial to mid-dorsal abdomen - right is usually cranial to left

Question 3

How do you measure kidney size?

Answer 3

Relative to length of L2 - dogs are 2.5-3.5 x longer

Question 4

Where does the bladder sit on radiograph? What is abnormal?

Answer 4

Lies entirely within abdomen
Neck level with pelvic brim
If neck is in pelvis then abnormal - female incontinence

Question 5

What can change the opacity of the bladder?

Answer 5

Radiopaque calculi
Emphysematous cystitis - gas production decreases opacity(associated with diabetes)

Question 6

What can you identify on retrograde contrast study of the urethra?

Answer 6

Rupture
Urethritis
Stricture
Tumour

Question 7

What does an abnormal prostate look like on radiograph?

Answer 7

Intra-abdominal

Question 8

What are the differentials for an enlarged prostate?

Answer 8

Benign prostatic hyperplasia
Prostatitis
Abscess
Neoplasia

Question 9

What can cause a soft tissue mass in caudal abdomen near the prostate?

Answer 9

Paraprostatic cyst

Question 10

What can you see on radiograph if there is a prostatic abscess?

Answer 10

Gas bubbles

Question 11

What does the uterus look like when pregnant?

Answer 11

5-6 weeks - large coiled tubular structure
6-6.5 weeks - foetal mineralisation

Question 12

What is a sign of lack of foetal viability?

Answer 12

Overlapping cranial bones (spaldings sign)

Question 13

What urinary tract contrast studies can you do?

Answer 13

IV urography - kidney, ureters etc.
Cystography - bladder
Urethrography - urethra

Question 14

What contrast should you use for urinary tract?

Answer 14

Water soluble iodinated contrast
NEVER barium - cant use IV

Question 15

When do you do an excretory urography?

Answer 15

Persistant UTIs
Urinary incontinence
Haematuria
Suspected renal abnormalities

Question 16

When do you take the radiographs for an excretory urography?

Answer 16

Immediately - nephrogram
5 mins - pyelogram (renal pelvis)
10 mins - ureterogram
15 mins - ureterovesicular junction

Question 17

What are the complications of an excretory urography?

Answer 17

Contrast-induced renal failure - uncommon, wont go opaque, usually reversible with fluids
Anaphylaxis

Question 18

What do renal cysts look like?

Answer 18

Oval structures of radioopacity or radiolucency in the kidney

Question 19

What is it called when the renal pelvis is very dilated?

Answer 19

Hydronephrosis

Question 20

What kinds of cystography can you do?

Answer 20

Pneumocystogram - air only
Positive contrast cystogram - iodinated contrast
Double contrast cystogram - both iodine and air

Question 21

What can you see on pneumocystogram?

Answer 21

Bladder location
Large masses
Marked thickening

Question 22

What can you see on positive contrast cystogram?

Answer 22

Leakage

Question 23

What can you see on double contrast cystogram?

Answer 23

Delineation of wall and content

Question 24

What are the indications for cystography?

Answer 24

Dysuria
Haematuria
Persistent UTIs
Pelvic trauma
Locate bladder

Question 25

What are the complications of cystography?

Answer 25

Iatrogenic rupture - overfilled
Damage to mucosa by catheter tip
Knotting of catheter - if too long, need to operate
Catheterise ureter/ectopic ureter - pyelonephritis
Air embolism - into blood vessel accidentally

Question 26

What can you see on urethrogram?

Answer 26

Ectopic ureter - bypassing bladder neck and merging with urethra
Urethral neoplasia
Urethral rupture