Imaging of the urological system Flashcards
1
Q
What is +ve contrast radiology?
A
- contrast elements that absorb a large amount of radiation - so white
- barium
- iodine
2
Q
What is -ve contrast?
A
- low density - dont absorb may x-rays
- CO2, air
- darker
3
Q
When would you use lateral or ventrodorsal recumbency?
A
- lateral - least superimposition on the abdominal structures - R better - kidneys more separated
- ventrodorsal - only if resp compromise
4
Q
What would contrast radiography be useful for?
A
- architecture that wouldnt be able to be seen normally
- ureter - course, diameter, filling
- bladder wall
- renal
- function
- GFR
- abnormalities
- masses
- calculi
5
Q
What is IVU?
A
- Intravenous urology
- renal architecture
- function - GFR
- ureteral abnormalities
- strictures
- ectopic
- iodine (+ve contrast)
- get pictures every 30 secs
- moves from renal pelvis, collecting ducts to the ureters, and measure GFR by speed of dye into bladder
6
Q
What does ultrasound allow?
A
- to differentiate between soft tissue and fluid
- fluid = anechoic - waves pass straight through - dark
- soft tissue = hyperechoic - reflect so light
- can get acoustic shadows - doesnt penetrate bone or air
7
Q
What do you assess with ultrasound?
A
- echogenicity
- shape
- size
- real time movement
8
Q
Describe the radiographical abnormalities of kidneys and ureters
A
- visibility
- decreased - trauma - retroperitoneal haemorrhage
- radiopacity
- increased
- nephrocalcinosis
- metabolic disease (hyperadreno, hypercalcaemia)
- chronic kidney disease
- ethylene glycol poisoning
- uroliths
- nephrocalcinosis
- decreased
- hydronephosis
- decrease in number of functional nephrons
- increased
- number
- congenital aplasia
- shape
- neoplasia
- ESK
- abscesses
- PCK - persians
- position + relationships
- ectopic kidneys
- nephromegaly
- displaces colon
- size
- smaller
- congential hypoplasia
- ESK
- bigger
- acute inflam
- neoplasia
- abscesses
- PCK
- pyelonephritis
- hydonephritis
- smaller
9
Q
Size of kidneys?
A
- dog = 2.5-3.5 x L2
- cat = 2.5 -3.0 x L2
10
Q
What would be seen when looking at kidneys and ureters (ultrasound)?
A
- kidneys
- capsule - thin hyperechoic
- cortex - hyperechoic to medulla (smooth and uniform)
- medulla - hypoechoic
- pelvis - lumen not seen - sinus with fat
- ureter
- confused with hilar blood vessels - Doppler
11
Q
What abnormalities of the kidneys can be seen using ultrasound?
A
- congenital
- aplasia
- hypoplasia
- inflam
- acute nephritis - increased echogenicity
- chronic nephritis - smaller/ loss of corticomedually contrast
- pyelonephritis - dilatation of pelvis and ureter
- abscesses - focal, hypoechoic massed
- Urolithiasis
- hyperechoic - bright masses
- trauma
- get hypoechoic blood in the retroperitoneal space
- PCK
- hypoechoic fluid inside
- Neoplasia
- loss of architecture
- Hydronephrosis
- back up of urine
- larger kidney
- dilatation of pelvis
- Amyloidosis
- proteinaceous
- hyperechoic
12
Q
What is perirenal effusion?
A
- fluid sitting around the kidney - haemorrhage
- hyperechoic line around it
13
Q
What type of radiography is used to view the bladder/urethra?
A
- negative contrast cystography (pseudocystogram)
- positive contrast cystography
- double contrast cystopgraphy
14
Q
What can be seen with a pseudocystogram?
A
- makes bladder much darker (+ve contrast)
- catheter - take fluid out - air in (CO2 - if worried of rupture)
- see bladder wall - thickness
- neoplasia
- inflammation
- cystitis - irregular
- transitional cell carcinoma - neck of bladder
15
Q
What is positive contract cystography used for?
A
- brighter
- see loss of architecture
- e.g. rupture, persistent urachus
- see mucosa a lot better
- may obscure calculi
