Renal Imaging

Question 1

What are the imaging modalities used for the Renal system?

Answer 1

CT
Ultrasound
MRI

Question 2

What are situations that may require imaging?

Answer 2

Mass imaging
Renal Trauma Eval
Eval of Hematuria
Kidney stones

Question 3

WHat kind of stones aren’t seen on CT?

Answer 3

Cysteine
Uric Acid Stones
All w/ Ca++ Will be seen

Question 4

Signs of Stones

Answer 4

Hydroureter
Perinephric Stranding
Soft tissue rim around white speck

Question 5

What is perinephric Stranding?

Answer 5

Smudging of the edges of the kidney on CT due to edema

Question 6

What is the DDx of Flank pain?

Answer 6

Diverticulitis
Appendicitis
AAA

Question 7

When is US appropriate for flank pain?

Answer 7

In pregnant patients. will miss 30% of stuff

Question 8

What is the goal of imaging in renal masses?

Answer 8

Used to charicterize the lesion and composition

Question 9

What does Anechoic or Sonolucent mean?

Answer 9

Cannot reflect sound waves. A cyst. Looks black on US

Question 10

What is attenuation in Imaging?

Answer 10

Decrease in intensity of the X-ray beam

Question 11

What is enhancement in Imaging?

Answer 11

Change in density of a tissue following admin of IV contrast

Question 12

What are Houndsfield Units?

Answer 12

Unit for attenuation values rang from (0 to 120?)

Question 13

What is a non-simple cyst?

Answer 13

Thick wall
Nodularity
Calcifications 
Septations
etc...

Question 14

What is the Bosniak Classification?

Answer 14

Class of Cystic Masses
I: Thin walls, benign
II
IIF: Need Follow up
III: Highly suspicious for malignancy, Ca++
IV: Known Malignancy

Question 15

WHat factors are evaluated in Mass Shape?

Answer 15

Shape

• tumefactive
• Infiltrating

Question 16

What is seen on Delayed enhanced CT of a benign Adenoma vs Malignancy?

Answer 16

adenoma takes up contrast.

High washout valuse