Radiologic imaging and hydronephrosis- MJ Flashcards
What 6 renal conditions do you use ultrasound for?
- Hematoma
- Seromas
- Lymphoceles
- Stones *
- Hydronephrosis*
- Renal Mass*
(*= can be evaluated by other imaging)
What 4 renal conditions do you use CT for?
What 2 renal conditions do you use MRI to evaluate for?
- Renal Mass*
- Renal Vein thrombosis*
(*= can use other imaging to evaluate for)
Which renal condition is evaluated for using Renal Arteriography?
RAS/RAT
Which renal condition do you evaluate for using renal venography?
Renal vein thrombosis*
(*= can use other imaging to evaluate for)
Which renal condition do you evaluate for using radionuclide studies?
Hydronephrosis*
(*= can use other imaging to evaluate for)
Which renal condition do you evaluate for using retro/anterograde Pyelography (IVP)?
Stones*
(*= can use other imaging to evaluate for)
Which 3 radiologic studies can be used to evaluate for renal stones?
- Ultrasound
- CT
- Retro/anterograde Pyelography (IVP)
Which 3 Radiologic studies can you use to evaluate for hydronephrosis?
- Ultrasound
- CT
- Radionuclide Studies
“RUC”
Which 3 common radiologic studies can you use to find a renal mass?
- Ultrasound
- CT
- MRI
(“MUC”)
Which 3 common radiologic studies can you use to find a Renal Vein Thrombosis?
- CT
- MRI
- Renal Venography
Which radiologic study?
- Safe and easy to use
- Initial testing/most commonly used
- Doppler can be used to assess vascular flow (RAS/RVT) but MR/CT more sensitive
Renal Ultrasonography
Which radiologic study is the choice for obstructive disease (stones) and is less sensitive for renal masses?
Renal ultrasonography
For obstructions proximal to ureter, otherwise US pelvis more useful
Which radiologic imaging?
- Complementary to US
- Avoids IV contrast (nephrotoxic)
- **Gold standard for renal stones**
- Locate ureteral obstruction
- Higher sensitivity for PKD
- Evaluate tumors
- Dx RVT
CT
Which radiologic study?
- Similar results as CT
- Preferred in children (reduced radiation compared to CT)
- Obstructive vs nonobstructive hydronephrosis
- Function of each kidney
Radionuclide scan
Which Radiologic study?
- Gold standard for RVT (along with renal venography and CT)
- Further evaluation of renal masses
MRI
When using MRI, you should use extreme caution giving gadolinium in patients with GFR < ______ mL/min.
Why is this?
- GFR < 30
- can lead to nephrogenic system fibrosis (NSF)
- Fibrosis of skin, muscle, fascia, lungs, and heart
- Wheelchair bound in weeks
- Only happens with renal failure
Which radiologic study?
- More invasive –> used less often than CT/MRI
- Used to identify arterial and venous occlusions
- Preferred test to identify Polyarteritis nodosa
Renal Arteriography and Venography
Which Radiologic Study?
- Assess caliceal anatomy, size of kidney, shape of kidney
- High sensitivity and specify for stones
- Substantial radiation and use of contrast therefore used infrequently
Intravenous Pyelogram (IVP)
(AKA IV urogram)
What are the 3 indications for renal biopsy?
- Nephrotic syndrome: SLE
- Nephritic syndrome
- Unexplained AKI
Renal biopsy is NOT indicated in patients with what 2 things?
- Isolated glomerular hematuria
- Low grade proteinuria
(this is because these can be investigated in other ways)
Wich renal condition?
- Unilateral or bilateral edema of the collecting system (fluid around the kidney)
- Usually asymptomatic
- +/- pain if obstruction involved
- +/- change in UOP
Hydronephrosis
- What are are obstructive etiologies of hydronephrosis?
- What radiologic study should be ordered?
- Bladder outlet obstruction- consider GI and GYN masses, stones, BPH
- US imaging
- What are nonobstructive etiologies of hydronephrosis?
- What radiologic study should be ordered if US is not diagnostic?
- Large diuresis can distend intrarenal collecting system (Diabetes insipidus)
- Order CT if US not diagnostic
How do you relieve hydronephrosis?
By stent
