Radiology of the Urinary System Flashcards
Are mens and womans kidneys the same size?
Kidneys are slightly larger in men than woman
How does kidney size change throughout life?
They increase in size up to age 20 and become smaller again in later life
What is renal blood flow in cc/min?
1200cc/min
How long is each kidney?
10-12cm
How long and wide are the ureters?
- 25-30cm long
- 3-8mm in diameter
What are the 3 points of narrowing in the ureters?
- PUJ
- Pelvic brim
- VU junction
How is the bladder peritonised?
Extra-peritoneal
What are indications for renal imaging?
- Renal colic and renal stone disease
- Haematuria
- Suspected renal mass
- UTIs
- Hypertension
What are some different imaging techniques for the urinary system?
- Plain film
- Advantages
- Cheap and readily available
- Functional and anatomical information (IVU)
- Disadvantages
- Low sensitivity and specificity for urological diseases
- Radiation
- Advantages
- Contrast studies
- IVU
- Pyelography
- Injection of contrast into the ureters
- Antegrade, retrograde, ileal conduit
- Cystography
- Micturating cystourethrography
- Vesico-ureteric reflux and its grade
- Ultrasound with or without contrast
- Advantages
- Cheap and readily available
- No radiation
- Contrast is not nephrotoxic
- Real time imaging
- Disadvantages
- Limited by body habitus and gas
- Poor visualisation of ureters
- Operator dependant
- No functional information
- Advantages
- CT and CTU
- Advantages
- Currently imaging modality of choice for detection of renal stones, staging renal tumours, investigation of haematuria
- Good spatial resolution with capability of multi planar reformat
- Disadvantages
- Radiation dose
- Cost
- Contrast resolution less than MR
- Contrast reaction and nephrotoxicity
- Advantages
- MR and MRU
- Advantages
- Multiplanar imaging
- Excellent contrast resolution
- Imaging of urothelium without contrast injection (MRU)
- Disadvantages
- Poor spatial resolution
- Poor detection of calcification and stones
- Cost
- Contraindications
- Pace maker, claustrophobia etc
- Contrast reaction and other side effects
- Advantages
- Isotope scans
- Different kinds
- DMSA
- To look for renal scaring
- MAG3
- Asses renal function and drainage
- Bone scan
- Metastatic disease such as prostate cancer
- DMSA
- Different kinds
- PET-CT
- Limited use in staging of urological malignancies due to high uptake in urine and variable uptake by tumours
- May be useful for extra-urological metastatic disease if other imaging modalities are equivocal or in poor surgical candidates
What are advantages of plain film imaging?
- Cheap and readily available
- Functional and anatomical information (IVU)
What are disadvantages of plain film imaging?
- Low sensitivity and specificity for urological diseases
- Radiation
What are examples of renal contrast studies?
- IVU
- Pyelography
- Injection of contrast into the ureters
- Antegrade, retrograde, ileal conduit
- Cystography
- Micturating cystourethrography
- Vesico-ureteric reflux and its grade
What is pyelography?
Form of imaging of the renal pelvis and ureter, can do a intravenous pyelogram – In which a contrast solution is introduced through a vein into the circulatory system
What is a cystography?
Imaging test that can help diagnose problems in your bladder. It uses X-rays.
What is micturating cystourethrography?
Technique for visualizing a person’s urethra and urinary bladder while the person urinates
