Post on 16-Jan-2016
• Intravenous urography
• Cysto-urethography
• Antegrade pyelography
• Retrograde pyelography
• Hysterosalpingography
• IONIZING RADIATIONIONIZING RADIATIONConventional (plain) radiography.
Contrast studies (X-Ray + Contrast)
Computed Tomography. Isotopic scanAngiography
• NONIONIZING RADIATIONNONIONIZING RADIATIONUS.
MRI.
KIDNEYS
URETERS
URINARY BLADDER
URETHRA
Conventional plain film of the abdomen is called a KUB (Kidneys, Ureters, Bladder)
Good evaluation of radio-opaque stones
This is KUB taken post intravenous contrast injection
KUB IVU
This is KUB taken post intravenous contrast injection
Also called IVP (intravenous pyelogram)Also called IVP (intravenous pyelogram)
Demonstrates both function and structure of the renal systemDemonstrates both function and structure of the renal system•Function ---Function --- FiltrationFiltration
•StructureStructure --- --- Contrast filled collecting systemContrast filled collecting system
Indications:Indications:•Urolithiasis / calculusUrolithiasis / calculus•PyelonephritisPyelonephritis•HydronephrosisHydronephrosis•TraumaTrauma•Tumour Tumour •Renal hypertensionRenal hypertension•Congenital abnormalityCongenital abnormality
Contra-Indications: (relative)Contra-Indications: (relative)•History of AllergyHistory of Allergy•AsthmaAsthma•Cardiovascular diseaseCardiovascular disease•Sickle cell diseaseSickle cell disease•Diabetes mellitusDiabetes mellitus
This is KUB taken post intravenous contrast injection
Renal Pelvis
Left Ureter
Urinary Bladder
• After IV injection,
sequential images are
taken in time order.
• Immediate post IV
• 5 min post IV
• 10 min post IV
This is KUB taken post intravenous contrast injection
Left Kidney
• Immediate post IV is nephrogram
Right Kidney
This is KUB taken post intravenous contrast injection
• 5 min post IV is nephrogram
This is KUB taken post intravenous contrast injection
• 10 min post IV is nephrogram
Renal Pelvis
Left Ureter
Urinary Bladder
Full Bladder20 min
KidneyKidney• Renal fasciaRenal fascia• HilumHilum• Renal sinusRenal sinus• Renal cortexRenal cortex
– Renal columnsRenal columns
• Renal medullaRenal medulla– Renal pyramidsRenal pyramids
• CalycesCalyces– Minor calycesMinor calyces– Major calycesMajor calyces– Renal pelvisRenal pelvis
Arterial
Venous Excretion
Non-contrast = Cortical
= Parenchymal
A 29 year old female patient presented to the emergency department complaining of acute sudden severe right flank pain radiated to the groin for 1 hour associated with hematuria.
•What is the likely diagnosis?•What investigation you will request?•What are the findings you expect to see?
Case one
Renal tract stone
Renal tract stone:
Renal tract stone
Renal tract stone:
Urinary tract stone
Case Two
A 36 year old male patient involved in road traffic accident. On examination patient is conscious oriented and in pain. Abdominal examination revealed diffuse guarding and tenderness.
What is the likely diagnosis?
What investigation you will request?
What are the findings you expect to see?
Case Three
A 54 years old female patient known case of diabetes and hypertension found to have high creatinine level.
What is the likely diagnosis?What investigation you will request?What are the findings you expect to see?
Hydronephrosis
Hydronephrosis
Case Four
A 49 years old male patient smoker for 30 years. Presented to primary health case with complaint of hematuria and weight loss. Patient denied history of flank or pelvic pain.
What is the likely diagnosis?What investigation you will request?What are the findings you expect to see?
Renal cell tumor
Transitional cell tumor
Renal cysts
polycystic kidney disease
Horseshoe kidney
Cross Ectopic Kidney