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Renal > Imaging of the kidneys and ureters > Flashcards

Imaging of the kidneys and ureters Flashcards

1
Q

Views of kidneys/ureters to take on xrays

A
    • orthogonal abdomen

- lateral abdomen/perineal region

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2
Q

Radiographic location/ appearance canine kidneys

A
  • retroperitoneal space
  • R. kidney more cranial –> renal fossa (T13-L2)
  • L kidney L1-4
  • bean shaped
  • smooth margins
  • soft tissue opacity
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3
Q

Radiographic location/appearance feline kidneys

A
  • retroperitoneal space
  • r. kidney more cranial in renal fossa
  • bean shaped
  • smooth margin
  • soft tissue opacity
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4
Q

Normal radiographic size - canine kidney

A

2.5 * 3.5 * L2

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5
Q

Normal radiographic size - feline kidney

A

1.9*2.6 L2 (2.1-3.2L2 for non-neutered cats)

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6
Q

Describe radiographic appearance - urinary bladder

A
  • variable size
  • pear shaped
  • soft tissue opacity
  • smooth margins
  • caudoventral abdomen: ventral to colon, ventral to uterus/uterine stump, cranial to prostate, normally cranially to pubis
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7
Q

Appearance - urethra

A
  • normally not seen

- deep in tissue

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8
Q

Normal radiographic anatomy of prostate

A
  • surrounding prostati urethra
  • ventral to colon
  • dorsal to pubis
  • perlvic inlet
  • size:
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9
Q

Normal radiograpic appearance of uterus

A
  • ventral to colon
  • dorsal to urinary bladder
  • variable size
  • tubular shape
  • smooth margins
  • soft tissue opacity
  • not always seen in all animals
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10
Q

When is the renal pelvis widened?

A
  • on fluids
  • pyelonephritis
  • obstruction
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11
Q

What is the cm size of renal for dogs and cats?

A
  • DOG: variable with breed (subjective evaluation)

- CAT: 3.9-4.4 or 3.66 +/- 0.46ccm (very important to measure size in cats

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12
Q

Outline ultrasound of urinary tract

A
  • difficult to see/ not visible when normal

- look for ureterovesical junction –> then turn on doppler to look for fluid flow

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13
Q

Describe prostate appearance on ultraound

A
  • homogenous echogenicity

- central urethra

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14
Q

Ultrasound of uterus

A
  • tubular structure
  • dorsal to bladder
  • echogenic line in middle = collapsed lumen
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15
Q

Another name for excretory urogragm?

A

= IV pyelogargm

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16
Q

Indications for contrast study

A
  • visualisation of size, shape, location, integrity of kidneys and ureters
  • qualitative assessment of renal function
17
Q

Example diagnoses of contrast studies

A
  • renal mass
  • renal dysplasia
  • ectopic ureter
  • hydropnephrosis
  • many others
18
Q

Describe the broad categories of contrast media

A
  • POSITIVE: show as white on xray, iodine or barium

- NEGATIVE: show as black on xray (gas, air O2)

19
Q

Describe barium as a contrast agent

A
  • never IV
  • looks like propofol but very dangerous if IV
  • use for skin or GIT only
20
Q

Outline iodine based contrast media

A
  • ionic vs non-ionic
21
Q

Contraindications - iodine based contrast media

A
  • dehydration
  • known hypersensitivity to I2
  • (heart failure)
  • azotaemia is not a CI if adequate hydration is provided
22
Q

Are ionic or non-ionic media slightly safer?

A

non-ionic contrast media

23
Q

Outline patient preparation for contrast studies

A
  • survey radiograph? (empty colon –> enema)
  • GA or heavy sedation
    +/- pneumocystogram
  • I2 based contrast medium (800ml/kg IV bolus)
  • radiographs at time intervals (VD views 0,2,5,10,15mins) lateral viuws (5,10,15 mins), consider oblique views
24
Q

What are the phases of contrast studies?

A
  • vascular phase (contrast through renal arteries)
  • nephrogram (tissue of kidneys visible)
  • pyelogram (contrast in renal pelvis and heading into ureters)
25
Q

What do you look for on ureters in contrast study?

A
  • location
  • shape
  • margins
  • opacity
  • number
26
Q

What should you do if you see large mass on kidney?

A
  • ddx - tumour, cyst
  • ultrasound/ CT
  • sample if neoplasia
27
Q

Indications

A
  • abdominal mass
  • abnromal renal or urinary profile
  • altered urination
  • abdominal/pelvic trauma

Renal (30 decks)

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