Radiology Assessment Flashcards
What can renal imaging decipher?
- exclude obstruction along the kidney, ureter, or bladder
- measure renal size (cortical thickness)
- cyst or solid
Types of renal imaging
- KUB
- Ultrasound
- IVP
- CT
- MRI
- Renal arteriography/venography
- retrograde or anterograde pyleography
- nuclear imaging studies
- voiding cystourethrogram
KUB
what is it?
what can it find?
what is it?
-Kidney-ureter-bladder (flat plate) X ray
what can it find?
-stones
Sonography (Ultrasound)
dependent on…
benefits
Dependent on operator! Limited by body habitus
Benefits
- fast and cheap
- no contrast
- safe (expectant mothers)
What is usually the first test done in renal disease?
Sonography!
Sonography
applications
appearance
Applications
- renal mass characterization (cyst vs solid, size, position)
- detects obstruction
- polycystic kidney disease
- chronic renal failure
Appearance
- ureteres not normally seen
- renal pelvis is black
- medullary pyramids are hypoechoic (dark)
- cortex is mid-grey, less echogenic than liver or spleen
- capsule is smooth and echogenic
Intravenous Pyelogram (IVP)
AKA
Googled explanation of what it is
Application
Mechanism
AKA
-pyelography, intravenous urogram
Googled explanation of what it is
-x-ray exam that uses an injection of contrast material to evaluate your kidneys, ureters and bladder
Application
-suspected obstruction of floe of urine and function of kidney
Mechanism
-Rapid IV bolus of dye with delayed films (get a baseline KUB and then again at 1, 5, 10, 15 min…)
CT Scan
Application
Types
Application
- evaluate renal tumors and local spread of renal malignancy
- trauma
Types
- High resolution CT angiography (with or without contrast), can detect smaller cyst (2-3 mm)
- CT urography (can identify urothelial tumors better than IVP
What is the gold standard for suspected stones?
CT scan!
-contrast will cover up the stone because they will both appear white
What test might be inferior to others due to gas bubbles?
KUB
MRI
Usually reserved for who?
Good for what type of masses?
Usually reserved for who?
-patients with CT contraindications (contrast)
Good for what type of masses?
- complex masses because MRI provides great tissue contrast
- “they don’t use MRIs much for nephrology” -Heath
Renal Arteriography
AKA
What is this?
What do you need to know?
Gold standard for what?
Benefit
AKA
-Aortography, angiogram
What is this?
- a special x-ray of the blood vessels of the kidneys
- Invasive with contrast
What do you need to know?
-Cr
Gold standard for what?
- Renal artery stenosis
- renal tumors (because it will give you a good mapping of the vessels)
Benefit
-you can stent with the angiography
Renal Venography
Useful for the dx of what?
Useful for the dx of what?
- renal vein thrombosis
- Tumors
-uses Xray, contrast, and fluoroscopy for monitoring
Retrograde/ Anterograde Pyelography
Good for dx of what
how does this work?
Good for dx of what
- urinary tract obstruction or tumors
- helps with placement of ureteral stents
- used to evaluate trauma (now we usually do CT or US)
how does this work?
- injects contrast into the ureter to visualize the ureter and kidney
- retrograde (dye injected in the direction of bladder to kidneys)
- antegrade (dye moving in the direction of kidney to bladder)
Nuclear imaging
Describe the process
benefits
Describe the picture
Describe the process
- pt lies still for clear pictures and a radioisotope tracer is injected into the vein
- a gamma camera detects the radioactivity and images are projected onto a computer
- can find out what % each kidney contributes to the total kidney function
benefits
- no side effects to the dye
- renal perfusion and function (dynamic renal scan, renogram, DTPA or Mag3 are all the dyes)
- obstruction (Lasix renal scan)
- Renovascular HTN (Captopril renal scan)
Describe the picture
- Its like they are taking the picture from behind, so the left side is actually on the left. (the left side should be higher)
- There are many pictures taken
