Imaging Flashcards
(33 cards)
Macroscopic haematuria investigation (over 50)
CT urogrpahy
Investigation of the under 50s with macroscopic haematuria
US of kidneys to detect calculi and renal parenchymal tumours
Cystoscopy to look for occasional bladder TCC, bladder calculi, other bladder tumours or evidence of urethritis/prostatitis
CTU only when US and cystoscopy are normal and macroscopic haematuria persists
(change in approach as incidence of urothelial tumours of kidney/ureter is very low in the under 50s)
the testis and/or epididymis is typically hypervascular on US
Epididymo-orchitis
the testis is typically avascular on US
Testicular torsion
dilated scrotal venous plexus
typically on left side
tortuous veins usually >2mm in diameter
Varicocele
Which side are you more likely to get hydrocele?
Left side
First line imaging test for suspected renal colic
KUB x-ray
How could you make the renal collecting systems, ureters and bladder visible?
Obtain x-rays folowing IV contrast injection
INTRA-VENOUS UROGRAM
Definitive test for symptomatic ureteric calculus
Non-contrast enhanced CT
Pregnant females (and young non-pregnant females if poss)
US and/or MRI
Macroscopic Haematuria
- over 50
- Kidneys, collecting systems and ureters
CT urogrpahy
Macroscopic Haematuria
- over 50
- bladder and urethra
Cystoscopy
gives option for ureteroscopy
to confirm tumour where CTU equivocal
to ablate tumours in patients unfit for nephroureterectomy
Cystoscopy
Most sensitive way to detect
Renal parenchymal tumours
Urotherlial tumours of the collecting system or ureters
CT urography
How do you carry out a CT urography?
1) do CT scan
2) give IV contrast
3) give 2nd shot of contrast (to enhance renal parenchyma)
4) do 2nd CT scan
Patients with contrast allergy, renal impairment, pregnant
MR urography
only use when CTU is contraindicated
Investigation to assess renal mass
CT
You find a mass containing fat
Benign - likely an angiomyolipoma
Difference between fluid cysts and complex cysts containing solid areas/thick septa
Simple fluid cysts - benign
Complex cysts - often malignant
Imaging for simple cysts
US
Renal tumour staging
CT
Imaging for pre-renal disease
MR angiogrpahy to detect RAS
Imaging for RENAL disease
US used to guide biopsy
Imaging for post-renal disesae
Hydronephrosis - US
Other causes of ureteric obstruction often require CT for diagnosis
