Lecture 22 - Imaging of the Urinary System

Question 1

How long are the kidneys?

Answer 1

10-12cm

Question 2

Kidneys increase in size until about the age of __ then they become smaller again in later life.

Answer 2

20

Question 3

How much does each kidney weigh?

Answer 3

120-170g

Question 4

What are the 3 constrictions of the ureters?

Answer 4

PUJ
Pelvic brim
VU junction

Question 5

What is the trigone?

Answer 5

Triangular area of bladder between ureteric and urethral orifices

Question 6

What are indications for renal imaging?

Answer 6

Renal colic/renal stone disease (diagnosis + follow up)
Haematuria
Suspected renal mass
UTIs
HTN

Question 7

What kind of contrast studies can you do to image the kidneys?

Answer 7

IVU
Pyelography
Cystography

Question 8

What is a pyelography?

Answer 8

Injection of contrast into the ureters

Question 9

What is a micturating cystourethrography used to assess?

Answer 9

VUR and its grade

Question 10

What kind of isotope scans may be used in renal disease?

Answer 10

DMSA
MAG3
Bone scan (e.g. to look for mets in prostate ca)

Question 11

What does a DMSA look for?

Answer 11

Renal scarring

Question 12

What does a MAG3 assess?

Answer 12

Renal function + drainage

Question 13

What is the best imaging modality to diagnose renal tract stones?

Answer 13

CT

Question 14

What is the best imaging modality to stage renal tract tumours?

Answer 14

CT

Question 15

How is a micturating cystourethrogram carried out?

Answer 15

Fill bladder with contrast via catheter and ask child to void
Images are taken during this phase to allow degree of reflux to be calculated

Question 16

How is IV urography conducted?

Answer 16

Administering IV iodinated contrast media
This is filtered by the kidneys and excreted and may provide evidence of renal stones/other structural lesions

(with non-contrast CT scans this is barely used now)