Download L1- radiology of the renal system 2

RADIOLOGY OF THE
RENAL SYSTEM
DR. Reshaid Aljurayyan
DEPARTMENT OF RADIOLOGY
Outline:
► Introduction
► Imaging
modalities used to study the
renal system
► Anatomy and normal appearance of the
renal system
► Common pathological cases
Introduction
► What
is the radiology?
Radiology is a medical specialty that employs
the use of imaging to both diagnose and
treat disease visualized within the human
body.
► What
is the renal system?
Outline:
► Introduction.
► Imaging
modalities used to study the
renal system.
► Anatomy and normal appearance of the
renal system.
► Common pathological cases.
What are the radiological
modalities that can be used to
image the renal system ?
Imaging modalities:
► Conventional
X-Ray
► IVU (intra-venous urogram) /
► US
► CT
► MRI
► Nuclear medicine
X-Ray + Contrast
Imaging modalities:
► Conventional
X-Ray
► IVU (intra-venous urogram) /
► US
► CT
► MRI
► Nuclear medicine
X-Ray + Contrast
Conventional Radiography (Xray)
►+ve:
 Cheap & widely available
 Often used as first choice
►-ve:
 Radiation
 Limited anatomy
► Used
for:
 Evaluate abdomen pain
 Some time good for diagnosing
kidney stones
lucent  black (air)
► Radio opaque  white
(bone/stone)
► Radio
Radiograph (X-ray)
Where are the kidneys ??
Radiograph (X-ray)
Where are the kidneys ??
IVU
► Same
as X ray but with
IV contrast
IVU
► +ve:
 Cheap & available
► -ve:
 Radiation
 Needs IV contrast (?reaction)
 Old (replaced by CT & MRI)
► Used
for:
 To diagnose kidney stones
 To diagnose hydronephrosis
US
► Ultrasound.
► Use
high frequency
sound wave.
► Contrast between
tissue is determined by
sound reflection.
►+
ve:
US
 Available
 No radiation
 Good anatomy
►-
ve:
 Operator dependent
► Used
for:
 Good for kidney stones
 Excellent for hydronephrosis
 Excellent for focal lesion e.g.
cysts, masses
 white
► Hypo-echoic  grey
► An-echoic black
(fluid)
► Hyper-echoic
►+
ve:
CT:
 Relatively available (more then
MRI)
 Very good anatomy
►-
ve:
 Radiation
 Some times need IV contrast (?
reaction)
► Used
for:
 Excellent for kidney stones (the
best)
 Excellent for hydronephrosis &
masses
 Excellent for kidney trauma
► Hyper-dense
white
(stone/bone)
► Hypo-dense grey to
black (fat/fluid)
CT
►+
ve:
 Excellent anatomy details
 No radiation
►-
ve:
 Expensive
 Long scanning time (30 to
60 min)
 Not used to diagnosed
kidney stone
► Used
for:
 Excellent for masses
 Good for hydronephrosis
MRI
► Hyper-intense
(white)
► Hypo-intense (grey to
black)
MRI
MRI
Nuclear medicine
►+
ve:
 Excellent to assess function
►-
ve:
 Radiation
 Poor anatomy details
► Used
for:
 Evaluated function
 Evaluated obstruction
Nuclear medicine
► Image
features:
► Projectional image.
► Image contrast by
tissue uptake and
metabolism.
NM
Objectives:
► Introduction.
► Imaging
modalities used to study the
back.
► Anatomy and normal appearance of the
back.
► Common pathological cases.
Case one:
► Young
male patient presented with left flank
pain and hematuria no fever and normal
WBC count.
Renal stones
Renal stones
Case two:
► Middle
age women complaining of flank pain
, fever and high WBC.
Inflammatory/ infectious
Case three:
► Old
male patient complaining of recurrent
renal infection.
Hydronephrosis:
Hydronephrosis:
Case four:
► Young
female presented with decrease renal
function (high urea and creatinine level).
Congenital:
Case six:
►
old male patient presented with pain less
hematura and weight loss.
Tumor:
Case seven:
Young male patient involved in road traffic
accident with blunt trauma to the abdomen.
Trauma: