Radiographs: Upper Urinary Tract

Question 1

location of kidneys

Answer 1

retroperitoneal space

Question 2

what surrounds the kidneys that provides contrast on rads

Answer 2

retroperitoneal fat

• high fat = increased margin visibility
• low fat = decreased margin visibility

Question 3

normal size of kidneys in cats

Answer 3

2-2.5x the length of L2 vertebrae

Question 4

normal size of kidneys in dogs

Answer 4

2.5-3x the length of L2 vertebrae

Question 5

shape of the kidneys

Answer 5

kidney bean shaped
smooth, rounded margins

Question 6

parameters to evaluate kidney abnormalities

Answer 6

size, shape, opacity, margins

Question 7

what would an enlarged RIGHT kidney displace

Answer 7

duodenum and ascending colon

Question 8

what would an enlarged LEFT kidney displace

Answer 8

descending colon

Question 9

ddx for enlarged kidneys with irregular margins

Answer 9

focal: masses, cysts
diffuse: hypertrophy

Question 10

ddx for small kidneys with irregular margins

Answer 10

chronic kidney disease
(causes fibrosis)

can see 1 enlarged kidney with 1 small kidney due to the other one compensating for the small kidney

Question 11

renal calculi

Answer 11

focal changes in opacity (mineralization)

can form anywhere along upper urinary tract - renal pelvis, calyces, ureters, bladder

Question 12

pyelectasis

Answer 12

dilation of the renal pelvis

Question 13

hydronephrosis

Answer 13

dilation of the renal calyces

**pyelectasis occurs before hydronephrosis

Question 14

hydroureter

Answer 14

dilation of the ureters

Question 15

ectopic ureter

Answer 15

ureter doesn’t connect to the proper part of the bladder (dorsal aspect); drains urine outside of bladder

Question 16

excretory urogram

Answer 16

evaluates the structures and function of the kidneys by injecting IV contrast and taking periodic radiographs

Question 17

urogram time intervals

Answer 17

time 0: angiogram
5 min: nephrogram
15 min: pyelogram

Question 18

angiogram

Answer 18

shows the renal blood vessels

Question 19

nephrogram

Answer 19

shows the renal parenchyma

outlines the kidneys - would be able to see masses/areas of necrosis

Question 20

pyelogram

Answer 20

shows the renal pelvis and ureters

ureters NOT normally visible on radiographs - need contrast

Question 21

where does the ureter insert into the bladder

Answer 21

DORSAL aspect