Imaging Flashcards
What types of diseases can simulate renal colic?
pyelonephritis and gynaecological disease
What should you do to excluse ureteric obstruction if pyelonephritis or gynae problems are suspected?
US
What is the first line test in patients with suspected renal colic?
KUB xray
What is the problem with KUB xray?
only a minority of renal calculi are visible on KUB xray
Why is KUB xray done first line instead of CT?
easy to obtain and may show dense ureteric calculus
What is the image of choice for renal colic?
unenhanced CT
Why are 2 xray plates done with KUB xrays?
generally abdomens are too large to fit on a single xray plate
What is the normal ureteric anatomy
pass inferiorly over psoas muscles; descend anterior to tips of lumbar transverse processes; corss the iliac bifurcation and enter the pelvis and pass posteromedially to enter the posterior aspect of hte bladder
What are the advantages of CT over IVU?
CT is quicker and there aren’t the risks assocaited with contrast; CT may show alternative diagnoses
What are the sites that ureteric calculi tend to get stuck?
pelviureteric junction; pelvic brim and vesicoureteric junction
What are the typical mimics of renal calculi?
phelboliths; lymph nodes; uretrine fibroids and arterial calcification
What are signs of obstruction?
perinephric stranding; hydroureteronephrosis
What patienst should CT be avoided in?
pregnancy and non-pregnant young females
After a stone has been identifed on CT why is an xray done?
to see if the stone is visible on xray for follow up purposes
What are hte possible causes of macroscopic haematuria?
calculi; infection; tumour; urethritis; trauma; clotting disorders
What are the investigations for patients over 50 with macroscopic haematuria?
CT urography; cystoscopy
What is the CTU the most sensitive way of detecting?
renal parenchymal tumours; urethelial tumours of hte collecting systems of ureters
What is the investigation of under 50s with macroscopic haematuria?
US; cystoscopy
When would CTU be done in patients under 50 with macrscopic haematuria?
when US and cystoscpy are normal and macroscopic haematuria persists
What is the difference between MR urography and CTU?
MRU is less sensitive for small calculi or upper tract TCC
What would fat in a renal mass indicate?
angiomyolipoma
What condition is angiomyolipoma assocaited with?
tuberous sclerosis
What are fluid density masses in the kidney?
cysts
What would indicate that a cyst is malignant?
contains solid areas or thick septa
How is CT used in staging of tumours?
can see local extent of tumour; nodal disease or metastatic spread
What is used for renal artery stenosis?
MR angiography
How is US useful in renal impairment?
distinguishing acute from chronic and to guide biospy
What may complicate epididymo-orchitis?
abscess formation or ischaemia
How does epidiymo orchitis appear on US?
hypervascular
How would testicular torsion appear on US?
avascular
What is varicocoele?
distended pampiniform plexus
What is a hydrocoele?
collection of fluid around the testis
How is renal injury best assessed?
by CT
What are signs of renal trauma on CT?
lack of enhancement of part of the kidney; extravasation of contrast
What is the more common mechanims of bladder rupture?
extraperitoneal
How is extraperitoneal bladder rupture treated?
conservativley
What causes intraperitoneal bladder rupture?
compression of full bladder
How is urnary tract trauma diagnosed?
cystography or CT cystography
What would suggest urethral trauma?
meatal bleeding and lack of UO
How are strictures in the urethra defined?
urethrography
What are the non-vascular radiology interventions?
nephrostomy to relieve ureteric obstruction; drainage of abscess or cyst; biopsy; guided ablation
What are the vascular radiology interventions?
correction of renal artery stenosis; control of arterial bleeding sites (embolisation); varicoceole embolisation
What type of imaging is nephrostomy done with?
fluoroscopy
How is embolisation of arteries carriedout?
metal coils
