Urinary Tract Urinary Tract

Dr. Nasr A. Mohammed Dr. Nasr A. Mohammed

FIBMSFIBMS

Imaging techniques Imaging techniques Basic examinationsBasic examinations

-Ultrasound.-Ultrasound.

-Intravenous Urography IVU.-Intravenous Urography IVU.

-Computed Tomography CT.-Computed Tomography CT.

-Radionuclide examination.-Radionuclide examination.

Other investigationsOther investigations

Magnetic Resonance Imaging MRI.Magnetic Resonance Imaging MRI. Arteriography.Arteriography. Direct puncture of collecting systemDirect puncture of collecting system

-Anatomical-Anatomical

-Functional-Functional

-both -both

Type of information they provideType of information they provide

ULTRASOUNDULTRASOUND

Is the first line investigationIs the first line investigation

The main uses of ultasound : The main uses of ultasound :

renal symptomsrenal symptoms

renal sizerenal size

hydronephrosishydronephrosis

renal masses renal masses

bladder and prostate bladder and prostate

Normal renal Ultrasound Normal renal Ultrasound

OutlineOutline Renal paranchymaRenal paranchyma Renal sinusRenal sinus Renal pyramidsRenal pyramids SizeSize

Small kindeysSmall kindeys

Unilateral but may be bilateral :Unilateral but may be bilateral :

chronic infection chronic infection

obstructive atrophyobstructive atrophy

RAS RAS

HypoplasticHypoplastic Always bilateral :Always bilateral : Chronic glomerulonephritisChronic glomerulonephritis Hypertensive nephropathyHypertensive nephropathy DM, collagen vascular diseaseDM, collagen vascular disease

Enlarged kidneysEnlarged kidneys Always unilateral : ?Always unilateral : ? May be unilateral or bilateral :May be unilateral or bilateral :

bifid collecting systembifid collecting system

renal mass renal mass

hydronephrosishydronephrosis

lymphoma lymphoma

renal vein thrombosesrenal vein thromboses Always bilateral :Always bilateral :

PCK PCK

AGNAGN

amyloidosisamyloidosis

UretersUreters

Urinary bladder Urinary bladder

distendeddistended

following micturition following micturition

UrographyUrography

Use of IV contrastUse of IV contrast

IVUIVU CT UrographyCT UrographyDetail of PCS Renal calculiDetail of PCS Renal calculi

Ureteric injury HematuriaUreteric injury Hematuria

Acute ureteric colic Renal massAcute ureteric colic Renal mass

Staging and follow up of CAStaging and follow up of CA

Renal vascular anatomyRenal vascular anatomy

renal trauma renal trauma

Intravenous urogramIntravenous urogram

Plain film ; Plain film ;

After contrast injection :After contrast injection :

--KidneysKidneys

positionposition

outline ( indentation , bulge )outline ( indentation , bulge )

renal length renal length

- - CalicesCalices : :

distribution distribution

shapeshape

dilatation dilatation

- - Renal plevis and uretersRenal plevis and ureters : :

shapeshape

dilatation dilatation

filling defectfilling defect

Bladder Bladder

OutlineOutline IndentationIndentation Emptying Emptying

CT urography CT urography

CT KUB : CT KUB :

Contrast :Contrast :

timing timing

MRI MRI

Indication :Indication :

Disadvantage : Disadvantage :

Radionuclide examination Radionuclide examination

Renogram ( DTPA ) Renogram ( DTPA )

Renal morphology (DMSA scan) Renal morphology (DMSA scan)

Voiding cystography Voiding cystography

Special techniques Special techniques

Retrograde and antegrade pyelographyRetrograde and antegrade pyelography

Micturating cystogram Micturating cystogram

UrethrographyUrethrography

Renal arteriographyRenal arteriography

Questions?Questions?