Renal and Urological Imaging Flashcards
most common cause of renal colic?
ureteric calculus
calculi are most easily seen on ___
CT
conditions of what systems can stimulate renal colic?
gynae
renal eg pyelonephritis
what imaging should you do if you suspect pyelonephritis as the cause of renal colic and why?
USS, excludes ureteric obstruction
1st line imaging test for a suspected renal calculus
KUB x ray
why do you commonly get 2 x rays for the ureters?
need abdo and pelvic as they are long and extend out of view
what part of the spine do the ureters pass in front of?
lumbar transverse processes
what muscles do the ureters pass inferiorly to?
psoas muscles
what are you looking for on imaging of the ureters?
strictures
filling defects
displacement of calices
what actually is an IV urogram?
x ray taken following an injection of contrast
other causes of calcification in the abdomen that can pose as a urinary tract calculus?
phleboliths
mesenteric lymph nodes
vascular calification
uterine fibroids (usually bigger)
is contrast used in a CT looking for kidney stones?
no
CT should be avoided in which patients in particular?
pregnant women (esp 1st trimester) young women in general
most calculi pass spontaneously: T or F
T
macroscopic haematuria is an uncommon disease: T or F
F, quite common
what kidney tumour is prevalent in all ages?
renal cell carcinoma
what tumour of the urinary tract is found in people over 45?
transitional cell carcinoma
what does a cystoscopy look at?
bladder and urethra
what does CT urography look at?
kidneys
collecting systems
ureters
why do we not use a contrast CT when looking for stones?
can mask stones as the contrast is white (stones show up white too)
lots of contrast is good for looking at what structures of the urinary system?
renal parenchyma
tumours
1st line investigation for >50 with haematuria?
CT urogram
1st line investigation for <50 with haematuria?
USS kidneys
cystoscopy
when is the only time you would do a CT urogram in <50s with haematuria?
when USS and cystoscopy are normal but haematuria persists
when would you do MR urography on a patient?
when CT urogram is contraindicated only (eg pregnancy, contrast allergy, renal impairment)
it is extremely uncommon for renal tumours under _cm to metastasise
2cm
what is an angiomyolipoma?
renal mass containing fat (benign)
Tx of angiomyolipoma?
follow up only to check for bleeding
solid masses larger than 4cm are often malignant T or F
F, >3cm
what investigation is 1st line for cyst diagnosis?
USS
what Ix is used to stage a malignant renal tumour?
CT
areas of metasases from kidney?
lung
bone
pre-renal causes of renal impairment?
dehydration
hypotension
renal artery stenosis
renal causes of renal impairment?
parenchymal disease
drugs
toxins
post renal causes of renal impairment?
obstruction
hydronephrosis often accompanies ___
obstruction
Ix for pre-renal disease?
MR angiography to detect renal artery stenosis
Ix of direct renal disease?
USS
the testis is typically hypovascular on USS in epididymoorchitis T or F
F, it is hypervascular
the testis is typically avascular on USS in testicular torsion T or F?
T
causes of painless scrotal swelling?
hernia
varicocele
hydrocele
epididymal cyst (v common)
varicocele commonly presents on what side?
left
what does hydrocele look like on USS?
black fluid around testicle
what part of the epididymis does a cyst usually arise on?
epididymal head
an intratesticular soft tissue mass is called?
testicular seminoma
renal trauma injury is best assessed by?
CT
is extra or intraperitoneal rupture of the bladder more common?
extra
how is extraperitoneal bladder rupture treated?
conservatively
how is intraperitoneal bladder rupture treated?
surgery
how is bladder trauma diagnosed?
cytography
what kind of trauma causes urethral disruption?
ant pelvic fracture
straddle injury
Tx for ureteric obstruction?
nephrostomy
ureteric stent
