Imaging of the kidneys and ureters Flashcards Preview

Renal > Imaging of the kidneys and ureters > Flashcards

Flashcards in Imaging of the kidneys and ureters Deck (27):
1

Views of kidneys/ureters to take on xrays

- - orthogonal abdomen
- lateral abdomen/perineal region

2

Radiographic location/ appearance canine kidneys

- retroperitoneal space
- R. kidney more cranial --> renal fossa (T13-L2)
- L kidney L1-4
- bean shaped
- smooth margins
- soft tissue opacity

3

Radiographic location/appearance feline kidneys

- retroperitoneal space
- r. kidney more cranial in renal fossa
- bean shaped
- smooth margin
- soft tissue opacity

4

Normal radiographic size - canine kidney

2.5 * 3.5 * L2

5

Normal radiographic size - feline kidney

1.9*2.6 *L2 (2.1-3.2*L2 for non-neutered cats)

6

Describe radiographic appearance - urinary bladder

- variable size
- pear shaped
- soft tissue opacity
- smooth margins
- caudoventral abdomen: ventral to colon, ventral to uterus/uterine stump, cranial to prostate, normally cranially to pubis

7

Appearance - urethra

- normally not seen
- deep in tissue

8

Normal radiographic anatomy of prostate

- surrounding prostati urethra
- ventral to colon
- dorsal to pubis
- perlvic inlet
- size:

9

Normal radiograpic appearance of uterus

- ventral to colon
- dorsal to urinary bladder
- variable size
- tubular shape
- smooth margins
- soft tissue opacity
- not always seen in all animals

10

When is the renal pelvis widened?

- on fluids
- pyelonephritis
- obstruction

11

What is the cm size of renal for dogs and cats?

- DOG: variable with breed (subjective evaluation)
- CAT: 3.9-4.4 or 3.66 +/- 0.46ccm (very important to measure size in cats

12

Outline ultrasound of urinary tract

- difficult to see/ not visible when normal
- look for ureterovesical junction --> then turn on doppler to look for fluid flow

13

Describe prostate appearance on ultraound

- homogenous echogenicity
- central urethra

14

Ultrasound of uterus

- tubular structure
- dorsal to bladder
- echogenic line in middle = collapsed lumen

15

Another name for excretory urogragm?

= IV pyelogargm

16

Indications for contrast study

- visualisation of size, shape, location, integrity of kidneys and ureters
- qualitative assessment of renal function

17

Example diagnoses of contrast studies

- renal mass
- renal dysplasia
- ectopic ureter
- hydropnephrosis
- many others

18

Describe the broad categories of contrast media

- POSITIVE: show as white on xray, iodine or barium
- NEGATIVE: show as black on xray (gas, air O2)

19

Describe barium as a contrast agent

- never IV
- looks like propofol but very dangerous if IV
- use for skin or GIT only

20

Outline iodine based contrast media

- ionic vs non-ionic

21

Contraindications - iodine based contrast media

- dehydration
- known hypersensitivity to I2
- (heart failure)
- azotaemia is not a CI if adequate hydration is provided

22

Are ionic or non-ionic media slightly safer?

non-ionic contrast media

23

Outline patient preparation for contrast studies

- survey radiograph? (empty colon --> enema)
- GA or heavy sedation
+/- pneumocystogram
- I2 based contrast medium (800ml/kg IV bolus)
- radiographs at time intervals (VD views 0,2,5,10,15mins) lateral viuws (5,10,15 mins), consider oblique views

24

What are the phases of contrast studies?

- vascular phase (contrast through renal arteries)
- nephrogram (tissue of kidneys visible)
- pyelogram (contrast in renal pelvis and heading into ureters)

25

What do you look for on ureters in contrast study?

- location
- shape
- margins
- opacity
- number

26

What should you do if you see large mass on kidney?

- ddx - tumour, cyst
- ultrasound/ CT
- sample if neoplasia

27

Indications

- abdominal mass
- abnromal renal or urinary profile
- altered urination
- abdominal/pelvic trauma