Urologic Imaging & Case Studies - CG

Question 1

What are some uses of cytoscopy?

Answer 1

• Bladder & Urethra visualization
• Lesion excision and biopsy
• Calculus removal
• Assist with radiographic studies
• Access to upper urinary tract for procedures/studies
• TURP

Question 2

What is prophylactic treatment for contrast-related renal dysfunction?

Answer 2

Hydrate with IVF, steroids and antihistamines

Use other agents in high risk patients

Question 3

An intravenous pyelogram (IVP) would be least effective for imaging:

1) obstructing stone in ureter
2) an avascular renal mass
3) urethral stricture due to BPH

Answer 3

C) urethral stricture due to BPH

Question 4

An ultrasound may be used to evaluate:
A) testicular mass
B) renal cysts
C) hydronephrosis
D) All of the above
E) A & B only

Answer 4

D) all of the above

Question 5

What imaging study is the most sensitive for renal calculi?

Answer 5

Spiral/Helical CT

Question 6

What are indications for MRI?

Answer 6

Very useful for soft tissue GU diagnosis (especially masses/prostate)

Question 7

What are indications for GU Ultrasound?

Answer 7

Modality of choice for:

• Evaluation of kidneys in many situations (cystic vs solid, fluid, etc.)
• Evaluation of testicular masses (cystic vs. solid)

Question 8

What are indications of a voiding cystogram?

Answer 8

Used to assess physiologic function

• Voiding difficulties
• Structural anomalies (diverticulum, vesicoenteric fistula)
• Stress urinary incontinence
• Sphincter dysfunction
• Post-operative bladder injury

Question 9

What do each of the three plain films (KUB) show during IVP?

Answer 9

1) scout film → shows bones, soft tissue, kidney stones,
2) nephrogram phase (2-3 min) → shows contrast in renal parenchyma possibly into the proximal ureters
3) excretion films (15-20 min) → shows contrast in ureters and bladder

Question 10

What are indications to Retrograde Pyelography (RGP)?

Answer 10

• When IVP is not adequate → better pictures needed, particularly of lower urinary system
• When patient is allergic to IV contrast or contrast is contraindicated
• During urologic surgical procedures

Question 11

What are indications for Radionuclide Imaging?

Answer 11

• Perfusion (blood flow) of kidneys
• Functional morphology (GFR & tubular function)
• Excretion

Question 12

What are indications for a Renal arteriogram?

Answer 12

• Aneurysm
• RAS
• Renovascular HTN
• Thrombosis
• A-V malformation