Imaging of the Renal System Dr. Reshaid Al Jurayyan Department of Radiology.
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Transcript of Imaging of the Renal System Dr. Reshaid Al Jurayyan Department of Radiology.
Imaging of the Imaging of the Renal SystemRenal System
Dr. Reshaid Al JurayyanDepartment of Radiology
Case (1)
• Young male patient presenting with left flank pain and hematuria, no fever and normal WBC count.
Case (6)
• Young male patient involved in a motor vehicle accident with sever blunt trauma to the abdomen.
INTRODUCTIONINTRODUCTION
• What is radiology? It is a medical specialty that employs
the use of imaging to both diagnosing and treating diseases within the human body.
• What is the renal system? Kidneys, ureters, urinary bladder and
urethra.
What What radiological radiological modalities modalities can be used can be used
to image the to image the renal renal systemsystem ??
IMAGING MODALITIESIMAGING MODALITIES
• Conventional radiography• Intravenous urogram (IVU)• US• CT• MRI• Nuclear medicine
Terminology
•X ray : Radio-opaque (white) vs radio-lucent (black)
•US: Hyper-echoic (white) / hypo-echoic(black)
•CT: Hyper-dense (white) / hypo-dense(black)
•MRI: Hyper-signal (white) / hypo-signal
•Nuclear med.: Highuptake(black) / lowuptake (white)
Conventional radiography
• First imaging modality in most cases.
• Cheap.• Useful for radio-
opaque stones.• Disadvantage :
radiation
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 radio-
opaque stones.• Disadvantage :
impaired the kidney
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.
• No radiation • Contrast between
tissue is determined by sound reflection.
US
Image features:• Operator
dependant.• Good resolution.• Used for stone,
hydronephrosis, focal lesion (ex. masses).
CT• Same basic
principle of radiography.
• More precise.• Costly.• +/- IV contrast.• Useful for trauma,
stone, tumor, infection.
• Best in stones
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.
• Good to assess kidney function.
• Less expensive.
Nuclear medicine
Image features:• Projectional image.
• Image contrast by tissue uptake and metabolism.
Case (1)
• Young male patient presenting with left flank pain and hematuria, no fever and normal WBC count.
• Kidney stones with hydronephrosis.• X-ray >> US >> CT
Case (2)
• Middle aged woman presenting with flank pain, fever and high WBC.
• Inflammation (e.g. Pyelonephritis)
•US >> CT+contrast >> MRI
Case (3)
• Elderly male patient with recurrent urinary tract infections.
• Bilateral hydronephrosis due to Prostate enlargement.
• US
Case (4)
• Young female presenting with decreased renal function (high urea and creatinine level).
• Polycystic.• US >> CT >> MRI• Contrast is contraindicated
Case (5)
• Elderly male patient with painless hematuria and weight loss.
• Tumor• MRI (BEST) >> US >> CT+contrast
Case (6)
• Young male patient involved in a motor vehicle accident with blunt trauma to the abdomen.
• Truma• CT (because it’s very fast)
األسئلة : • عن الدكتور سألتجاه واحد مثال وبتكون بالنظري األسئلة تكون راح يقولخاصية وكذلك هذا؟ للشيء أشعة افضل وش حادث
األجهزة
البريدي حمد