Revise Radiology Genitourinary Flashcards
Wedge shaped hypodensities in kidneys on cortical phase
Renal infarct
Cortical rim sign
Renal infarct
Thickened endometrium on breast cancer treatment
Tamoxifen induced changes
Small painless bumps on face and neck, spontaneous pneumothorax, renal tumours
Birt-Hogg-Dube
Nephrogenic systemic fibrosis
Thickening and hardening of skin and subcutaneous tissues
Joint stiffness and pain
Associated with chronic renal failure and exposure to gadolinium
Testis MRI appearance
Intermediate on T1, high on T2, avid diffusion restriction
Urethral injury classification
Goldman:
Type 1: Stretching of the posterior urethra
Type 2: Posterior urethral injury ABOVE urogenital diaphragm
Type 3: Injury to membranous urethra, extending into proximal bulbous (laceration of urogenital diaphragm)
Type 4: Bladder base injury involving neck, extending into proximal urethra
Type 4a: Bladder base not involving bladder neck (identical to type 4 on imaging)
Type 5: Anterior urethral injury (isolated)
Round hyperintense T2 lesion lateral to external urethral meatus
Skene duct cyst
MEN features
1: PPP (Primary = 1)
Pituitary
Parathyroid
Pancreatic islet cell
2A: PPM
Phaeo
Parathyroid
Medullary thyroid
2B: PMM
Phaeochromocytoma
Medullary Thyroid Cancer
Mucosal Neuromas/Marfanoid
Phaeochromocytoma MRI
High T2, avid enhancement, rarely calcify
Node involvement in bladder cancer
Obturator, presacral, internal and external iliac are regional.
Common iliac are distant mets
Lobar parenchymal calcifications, thick calcified ureter with structure
Genitourinary TB
Most common association with horseshoe kidney
Turner syndrome
Cervical cancer MRI
Cancer is T2 intense, which differentiates it from hypointense stroma
Commonest vaginal tumour in children
Vaginal rhabdomyosarcoma
Adrenal washout
Absolute:
(PV-Delayed)/(PV-Unenhanced)
>60% suggests adenoma
Relative:
(PV-Delayed)/PV
>40% suggests adenoma
Commonest genital outflow abnormality
Imperforate hymen
Homogenous hypoechoic round mass replacing entire testicle
Seminoma
Normal prostate MRI
Peripheral zone enhances more than central zone
Testicular rupture vs fracture
Rupture:
Disrupted tubica albuginea.
Heterogenous testicle.
Poorly defined testicular outline
Fracture
Intact tunica albuginea.
Linear hypoechoic band across testicle
Well defined testicular outline
Pelvic fractures typically cause (bladder)
Extraperitoneal rupture
Syndrome associated AML vs sporadic
Syndromic (TS) tend to be multiple/bilateral
Testicular neoplasm doppler
Usually shows normal or increased vascularity
Hairy kidney and coated aorta sign
Erdheim Chester disease
Ix for post traumatic assessment of bladder injury
CT cystography
Pelvic fractures and urethral injries
Posterior is more common, seen in up to 20% of pelvic fractures in males.
Males > Females
Smooth, oblong mobile filling defect in the renal pelvis
Fibroepithelial polyp
Poorly defined hypoechoic or hyperechoic areas in renal parenchyma.
Low density on CT, extending from medulla to cortex
Lobar nephronia
Clubbed calyces, calcifications, altered renal contour
Papillary necrosis
Goblet shape on CT IVP
Transitional cell carcinoma
Bosniak cysts
1: Thin wall, no septa, calc, enhancement
2: Few septa or thin calcifications
2F: Minimally thickened, smooth walls, thicker/nodular calcification
3: Thickened, irregular walls or enhancing septa
4: Enhancing soft tissue component independent of wall or septum
Phantom calyx
Infundibulum stenosis causes lack of opacification,
Suggests renal TB
Very FDG avid retroperitoneal lesion
Hibernoma
Thin cortical calcification and tramlines on unenhanced CT
Renal cortical necrosis
Ix for PUJ obstruction
Diuretic renography
Renal cyst with uniform wall thickening
Bosniak 3
Thickened endometrium on US, next step
Biopsy
CT protocol for ?pyelonephritis
Split bolus arterial and nephrogenic phase (80-100 seconds)
Vesicoureteric reflux grading
Grade I: reflux into non dilated ureter
Grade II: Reflux into non dilated renal pelvis
Grade III: Reflux into renal pelvis with mild-moderate dilatation of ureter and pelvis
Grade IV: Moderately dilated ureter and pelvis with blunting of fornices
Grade V: Reflux into grossly dilated ureter and pelvis with tortuosity and loss of papillary impressions
Medial deviation of right ureter
Retrocaval ureter
Tramline calcification of cortices with increased echogenicity of kidneys
Acute cortical necrosis
Polypoid mass in bladder resembling bunch of grapes (child)
Rhabdomyosarcoma
MRI sequence to distinguish clot from calculus
T1 (clot is hyperintense)
Ureteritis cystica Rx
Treat underlying infection
Which testis is more susceptible to blunt trauma
Right (higher up)
Normal MRI penis enhancement
Corpus spongiosum enhances more rapidly than cavernosa
Contrast extending into perineum on cystography
Implies complex extraperitoneal bladder rupture
Septum extending through the cervix and vagina
Septate uterus
Vaginal surgery increases risk of
Rectocele
Upper pole moeity in duplex system usually…
…ends in ureterocele
Commonest site of BPH nodules
Transitional zone
Features of adrenal cortical carcinoma
Central necrosis
Calcifications
Cushing’s syndrome
Acute flank pain, flank mass, hypovolaemic shock
Winderluch syndrome
Plaques within tunica albuginea
Peyronie’s disease
lesion centred in tunica albuginea with extension into testicular parenchyma
Adenomatoid tumour
Hyperechoic renal medullae with cysts
Medullary sponge kidney
retroperitoneal air may indicate
Pulmonary injuries
Adrenal lesion <10HU unenhanced
Suggests benign
Septate vs bicornate uterus
Septate has normal external fundal contour
Commonest congenital uterine abnormality
Septate uteruus
Commonest urinary tract cancer
TCC
Commonest site of TCC
Bladder, then renal pelvis
Leukoplakia vs malakoplakia
Malakoplakia involves ureters and is less common in men
Fluid collection 6 weeks post renal transplant. Bloods OK
Lymphocele
Mass forming from an organ with have x angles with it
Acute
paintbrush appearance
Medullary sponge kidney
PIRADS 4 vs 5
PIRADS 5 >1.5cm
t2 dark ring disrupted
Suggests parametrial invasion, stage 2B, needs chemo/radio
swiss cheese appearance in prostate
Prostate abscess
Purpose of ultrasound in neonate with ?VACTERL
Assess genitourinary defects
PCOS US diagnosis
Twelve or more follicles (3-12mm) in an ovary.
Ovarian volume >10ml when no follicles over 10mm