Imaging in Renal Disease Flashcards
RENAL COLIC
What is the first imaging test which should be done?
Will this show a calculi?
If a calculi is seen on this test, what imaging should be used for follow up?
Abdominal (KUB) X-ray
Only a minority of calculi will show on this test
Abdominal (KUB) X-ray
RENAL COLIC
What is the gold standard imaging test?
As well as the calculi, what else may this test show?
Calculi which are caused by what, may not be seen on CT?
When should this test be avoided?
If this test cannot be performed, what can be used instead?
Non contrast enhanced CT
Signs of obstruction
Anti-retroviral associated stones
Pregnancy, and ideally in young, fertile females
Ultrasound or MRI
RENAL COLIC
If you suspect pyelonephritis, what test should be done to exclude an obstruction?
If you suspect gynaecological disease, what test should be done to visualise uterine, ovarian and tubal pathology?
Ultrasound
Ultrasound
MACROSCOPIC HAEMATURIA
What imaging tests are used in an individual who is aged > 50?
Why are investigations more intense in this age group?
CT urography (contrast)
Cystoscopy
Higher risk of TCC
MACROSCOPIC HAEMATURIA
A CT urogram is used in the investigation of those aged > 50. This can also be known as a triple phase CT. What does this involve?
CT scan without contrast (best to detect stones)
CT scan with contrast in the collecting ducts
CT scan with contrast in the kidney parenchyma
MACROSCOPIC HAEMATURIA
What imaging tests are used in the investigation of someone aged < 50?
When should CTU be used?
US scan of kidneys (for calculi/tumours)
Cystoscopy
If macroscopic haematuria persists, and the above investigations are normal
MACROSCOPIC HAEMATURIA
Does an MR urogram involve contrast?
When would an MR urogram be indicated?
An MR urogram is less sensitive than a CT urogram for what?
No
Contrast allergy, pregnancy, renal impairment
Small calculi and upper tract TCC
RENAL MASSES
What is the best test to assess a renal mass?
What test is used for renal tumour staging?
What test is sufficient to diagnose a renal cyst?
What test is used in pregnant/young females?
CT
CT
Ultrasound
MR with contrast
RENAL IMPAIRMENT (AKI)
What test is used for pre-renal disease?
What test is used for renal disease?
What tests can be used for post-renal disease?
MR Angiography
US (for biopsy)
US/CT
SCROTUM
What test is best used to investigate the scrotum?
In epididymo-orchitis, the testes/epididymis will generally have what appearance?
In testicular torsion, the testes will generally have what appearance?
Ultrasound
Hypervascular
Avascular
TRAUMA
Renal injury is best assessed with what test?
Bladder trauma is best investiagted with what tests?
CT
Cystography/CT cystography
