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Imaging of the Renal System Dr. Reshaid AlJurayyan Department of Radiology OUTLINE • Introduction • Imaging modalities • Anatomy • Cases INTRODUCTION • What is radiology? It is a medical specialty that employs the use of imaging to both diagnose and treat disease within the human body. • What is the renal system? Kidneys, ureters, urinary bladder and urethra. IMAGING MODALITIES • Conventional radiography • Intravenous urogram (IVU) • US • CT • MRI • Nuclear medicine Conventional radiography • First imaging modality. • Cheap. • Useful for radioopaque stones. Conventional radiography Image features: • Projectional image. • Image contrast determined by tissue density. • Good evaluation radio-opaque stones. IVU • Conventional x-ray plus intravenous contrast. • Cheap. • Recently replaced by CT and MRI. • Useful for radioopaque stones. IVU Image features: • Projectional image. • Image contrast determined by tissue density and IV contrast. • Good evaluation of collecting system and radio-opaque stones. US • Use high frequency sound wave. • Contrast between tissue is determined by sound reflection. US Image features: • Operator dependant. • Projectional image. • Good resolution. • Used for stone, hydronephrosis, focal lesion. CT • Same basic principle of radiography. • More precise. • Costly. • +/- contrast. • Useful for trauma, stone, tumor, infection. CT Image features: • Cross sectional images. • Image contrast determined by tissue density +/contrast. • Better evaluation of soft tissue. MRI • Better evaluation of soft tissue. • Expensive. • Useful for soft tissue pathology: tumor, infection. MRI Image features: • Cross sectional images. • Image contrast determine by tissue properties. • Excellent for soft tissue evaluation. Nuclear medicine • Utilizes a gamma camera and radioactive isotopes. • Functional test. • Less expensive. • Useful for: obstruction and split function. Nuclear medicine Image features: • Projectional image. • Image contrast by tissue uptake and metabolism. ANATOMY CASES • What are the imaging modalities? • What are the findings? • Diagnosis? Case (1) • Young male patient presenting with left flank pain and hematuria, no fever and normal WBC count. Case (2) • Middle aged woman presenting with flank pain, fever and high WBC. Case (3) • Elderly male patient with recurrent urinary tract infections. Case (4) • Young female presenting with decreased renal function (high urea and creatinine level). Case (5) • Elderly male patient with painless hematuria and weight loss. Case (6) • Young male patient involved in a motor vehicle accident with blunt trauma to the abdomen. Renal trauma grading THANK YOU