Genitourinary radiology Flashcards
what is the gold standard test you’d use for a patient who you suspect has a renal calculus?
CT KUB without contrast
what is disadvantage of using plain x rays to screen for renal calculi?
hard to tell the difference between renal calculi and phleboliths
what does CT KUB stand for?
kidney ureters bladder
what is the main role of imaging in investigating haematuria?
to search for a post glomerular cause of the haematuria (e.g. not glomerulonephritis)
when would you do a CT KUB with contrast?
to investigate possible renal tumour
what type of urinary stones are radio-opaque and radiolucent on imaging?
Radio-opaque= calcium, struvite Radiolucent= uric acid, xanthine, mucoprotein
what is an IVP?
intravenous pyelogram- a preliminary AXP is obtained, and then water soluble contrast is injected intravenously and subsequently excreted by the kidney over 15-45 mins. During the 10-15 mins X-rays are taken in 3 phases; 1st phase= initial nephrogram; 2nd phase= excretory phase; 3rd phase= drainage phase
how do you tell if the IVP is in the arterial phase?
aorta shines bright/ dense
what cancers do you look for for haematuria?
transitional cell carcinoma, renal cell carcinoma
what do TCC look like on CT?
lobular structure
what type of imaging do we prefer for cancer?
CT, although U/S may be used.
when you see one TCC,what else do you look for?
more TCC. as they can be multifocal
what are some limitations of renal artery doppler u/s?
patient needs to hold their breath while during the u/s- so patient cooperation. Patient body habitus may also obscure the ultrasound beam. Bowel gas can also be in the way. If the artery is heavily calcified it can also cause difficulties for the doppler
what other imaging studies could you perform if renal doppler us is suboptimal?
CT or MRI
how would you describe a renal abscess, or any abscess on CT contrast?
rim enhancing lesion
