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Module 17 > Diagnostic Imaging of Urinary System > Flashcards

Diagnostic Imaging of Urinary System Flashcards

1
Q

what is the renal length of the kidneys in dogs

A

2.5-3.5 times the length of L2

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2
Q

what is the renal length of the kidneys in cats

A

in neutered cats 1.9-2.6/entire 2.1-3.2 times the length of L2

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3
Q

what are the positive contrast cystogram used for contrast rads

A

iodine contrast medium

catheter into bladder

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4
Q

what is negative contrast cystogram

A

air

bladder position, wall thickness

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5
Q

what is double contrast cystogram

A

combination of 1-5ml contrast then air

position, luminal content, wall thickness

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6
Q

what is a retrograde urethrogram

A

male

catheter in distal urethra

demonstrates urethra

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7
Q

what is a retrograde vaginourethrogram

A

female

catheter through vulva

demonstrate vestibule, vagina and urethra

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8
Q

what are the two views of the kidney on ultrasound

A

long axis

short axis

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9
Q

where do you scan the right kidney

A

scan between ribs

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10
Q

what is the difference between cats and dogs when scanning the kidneys with ultrasound

A

mobile so variable position

more rounded in outline

corticomedullary rim sign more common

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11
Q

what does the US renal assessment (7)

A
  1. location
  2. size
  3. shape
  4. margins
  5. components: cortex, medulla, corticomedullary junction, pelvis, ureter
  6. echogenicity
  7. echotexture
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12
Q

what are differential diagnosis of diffuse parenchymal changes (5)

A
  1. acute renal disease/failure
  2. chronic renal disease
  3. renal dysplasia
  4. chronic endstage kidney
  5. neoplasia (lymphoma)
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13
Q

what are ddx of pelvic dilationhydronephrosis (3)

A
  1. obstruction
  2. pyelonephritis
  3. neoplasia
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14
Q

what are ddx of focal changes in the kidneys (4)

A
  1. neoplasia
  2. calculi
  3. cysts
  4. abscesses
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15
Q

what would acute kidney disease look on US

A

rounded, hazy kidney

reduced corticomedullary definition (nephritis, tubular necrosis, acute renal failure, ethylene glycol toxicity)

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16
Q

what changes are seen here and what would the ddx be

A

rounded hazy kidney

reduced corticomedullary definition

acute renal disease

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17
Q

what changes are seen here

A

hyperechoic kidney with rim sign

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18
Q

what are the chronic renal disease changes on US

A

changes are non-specific

often bilateral

heterogenous cortices

reduced cortico-medullary definition

indentations suggest old infarcts

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19
Q

what are the changes shown here

A

hetergenous cortices

reduced cortico-medullary definition

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20
Q

what changes are shown here

A

indentations suggest old infarcts in kidney in chronic renal disease

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21
Q

what changes would be seen in renal dysplasia in US (3)

A
  1. loss of corticomedullary definition
  2. distored outline/abnormal shape
  3. small/difficult to recognize
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22
Q

what are changes seen in chronic endstage kidneys

A

loss of normal architechture

small/may be difficult to identify

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23
Q

what changes are shown here

A

renal dysplasia

loss of corticomedullary definition

distorted outline/abnormal shape

small/difficult to recognize

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24
Q

what changes are shown here

A

loss of normal architecture of kidneys

small

chronic endstage kidney

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25
Q

what is the best view on US to assess pelvic size and hydronephrosis

A

short axis

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26
Q

what is shown here

A

pelvic dilation/hydronephrosis

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27
Q

what would the changes be in a urethral obstruction

A
  1. pelvis normal shape
  2. ureter visible to point of obstruction
  3. check bladder neck and other kidney
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28
Q

what changes are seen in neoplasia

A

irregular/abnormal shape to pelvis

disrupted architecture

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29
Q

what changes are seen here

A

neoplasia

irregular/abnormal shape to pelvis

disrupted architecture

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30
Q

what changes are seen here

A

pyelonephritis

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31
Q

what could be seen with renal masses on US (4)

A
  1. disruption of normal renal architecture
  2. distortion of outline/abnormal shape
  3. may be difficult to identify kidney
  4. FNA/biopsy for diagnosis
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32
Q

what are the changes seen here

A

renal mass

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33
Q

what is seen here

A

renal mass

34
Q

what is seen here

A

renal mass

35
Q

what can be seen with calculi on US

A

hyperechoic mass with acoustic shadowing

36
Q

what is shown here

A

renal calculi

37
Q

where are renal calculi located

A

located in the calyces/pelvis

38
Q

what are the appearance of cysts on US

A

anechoic/cloudy

located anywhere

single/multiple

39
Q

what are the causes of renal cysts

A

congenital

associated with chronic inflammation

polycystic kidney disease (PKD)

40
Q

what are the appearance of abscess on US

A

anechoic/cloudy

irregular margins

surrounding reaction

located anywhere

41
Q

is this a normal bladder appearance

A

yes

the sludge is an artefact

42
Q

how thick is the bladder wall normally

A

1-2mm

43
Q

what should be assessed in the urinary bladder (4)

A
  1. location
  2. size
  3. components: wall, neck
  4. contents: artefacts, gravity
44
Q

what are ddx for wall changes of the bladder

A

cystitis

mass: neoplasia, inflammaotry polyps

rupture

45
Q

what are ddx for contents in the bladder

A

calculi

blood clots

cell debris

emphysematous cystitis

46
Q

what are the changes seen in cystitis

A

increased wall thickness (>0.2cm)

bladder must be distended

uniform vs focal (cranioventral)

47
Q

what changes are seen here

A

thickening and distended bladder wall due to cystitis

48
Q

what changes are seen here

A

diffuse changes in the cranial ventral border

cystitis

49
Q
A
50
Q

what are the ddx of bladder masses

A

neoplasia

inflammatory polyps

51
Q

what is the classic location for transitional cell carcinomas

A

trigome of the bladder neck

52
Q

what is shown here

A

pedunculated mass = polypoid mass

53
Q

what is shown here

A

mass in bladder neck

54
Q

what is shown here

A

irregular with broad based attached = sessile (neoplasia)

55
Q

what types of calculi can be seen on imaging

A

struvite, oxalate radioopaque

cystein, urate are lucent

56
Q

what is seen here

A

calculi in bladder

57
Q

what is shown here

A

gravel, small clusters of calculi

58
Q

what can be seen in the bladder contents (5)

A
  1. concentrated urine
  2. cell debris
  3. hemorrhage
  4. mucous
  5. wall unaffected
59
Q

what is shown here

A

blood clots in bladder

60
Q

what is the landmark to locating the prostate on US

A

bladder

prostate is around proximal urethra

61
Q

what is the appearance of the prostate on US

A

bilobed

echogenicity similar to spleen

capsule

62
Q

what is shown here

A

prostate

63
Q

what should you assess the prostate (6)

A
  1. location
  2. size
  3. shape
  4. margins
  5. echogenicity
  6. echotexture
64
Q

what are ddx to parenchymal changes (3)

A
  1. benign prostatic hyperplasia
  2. prostatitis
  3. neoplasia
65
Q

what are ddx for fluid lesions (3)

A
  1. cysts
  2. abscess
  3. paraprostatic cysts
66
Q

what is the appearance of benign prostatic hyperplasia on US (4)

A
  1. hyperechoic
  2. heterogenous
  3. radiating pattern
  4. +/- cysts
67
Q

what is shown here

A

benign prostatic hyperplasia

68
Q

what will acute inflammation of the prostate look like on US

A

hypoechoic

69
Q

what will chronic inflammation of the prostate look like on US

A

hyperechoic & mottled

70
Q

what is shown here

A

chronic inflamamtion of prostate

hyperechoic and mottled

71
Q

what is seen here

A

acute inflammation of prostate

hypoechoic

72
Q

what is the appearance of prostate neoplasia (3)

A
  1. mottled
  2. mineralization
  3. locally invasive
73
Q

what is seen here

A

prostate neoplasia

74
Q

what changes can be seen with prostate neoplasia on radiographs

A

new bone formation pelvis and lumbar vertebrae

75
Q

what are fluid filled lesions of the prostate

A

prostatic cysts

76
Q

where are prostatic cysts seen

A

within prostate

77
Q

what are the appearance of prostatic abscess

A

indistinct margins

cloudly contents

surrounding reaction

78
Q

what are paraprostatic cysts

A

outwith prostate

79
Q

how do you paraprostatic cysts seen on imaging

A

can displace bladder

mineralized rim on radiograph (~50%)

80
Q

how are ectopic ureters seen on US

A

visible if distended

insertion not visible if beyond pelvic inlet

Module 17 (31 decks)

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