Flashcards in Imaging UUT kidneys, ureters and prostate/uterus Deck (29)
- abdo mass
- abnormal renal/urinary profile
- altered urination
- abdo/pelvic trauma
Which views are necessary for urogenital tract rads?
- plus butt shot lateral of caudal abdo/perineal region
What are the Roentgen signs of the kidneys?
- Position: Retroperitoneal space (R cranial: renal fossa of liver T13-L2, L caudal: L1-L4)
- Shape: Bean shaped
- Margins: Smooth
- Opacity: Soft tissue
- Number: 2
How do cats kidneys differ to dogs?
- sit more caudally
- more ventrally
- both ~ L2-L5
Normal size of the kidneys
- measure on VD view
- 2.5-3.5 x L2
- 1.9-2.6 x L2 (Intact male: 2.1-3.2 x L2)
Are ureters normally visable on rads? Where do they go?
- exit middle dorsal aspect of the kidneys
- course caudally
- "shephards crook" before entering trigone of bladder
> not normallly visable unless cat very fat
Roentgen signs of bladder
>Shape: Pear shaped
>Opacity: soft tissue (needs to be full to be more visable)
>Location: Caudoventral abdo
- Ventral to colon, uterus/stump
- Cranial to prostate
- Normally cranially to pubis
Is the urethra normally seen on rads?
- oz penis can be seen (dogs and some male cats)
How does the urethra differ in females and males?
- females straight out through pelvis
- males courses back round the very caudal end of the body and down to os penis and out
- both only course straight out the back
What may be seen concurrently with nephromegaly? What may this indicate?
- ventral displacement of intestines
> doesnt differentiate tumour, hydronephrosis etc.
What will be seen with nephrolithiasis? What does this tell you?
- altered opacity
> doesnt tell you if inflammation/obstruction present
Roentgoen signs of the prostate
> Size: Shape: oval - round
> Opacity: soft tissue (cats not visable, dogs can see well)
> Margins: smooth
> Location: surrounding prostatic urethra
- caudal to bladder
- ventral to colon (will always push up)
- dorsal to pubis
- pelvis inlet
What is a sign of malignancy in prostatic disease? Which dogs would you suspect to get this?
- mineralisation in the prostate
- NEUTERED dogs (esp those neutrered at an early age)
> entire dogs get benign hyperplasia/prostatitis which may also mineralise but be more worried in neutered dogs
Where should you look to find effusions?
Fat Triangle between rectum, rectus abdominis, bladder and prostate
- if you have normal peritoneal detail
ROentgen signs of uterus
> Size: Variable
> Shape: Tubular
> Opacity: soft tissue
> Margins: Smooth
> Location: Ventral to colon, dorsal to urinary bladder
- not visable in every animal
What can be differentiated with ultrasoudn of the kidney?
- hypoechoic cf. cortex
- obstruction/hydronephritis/on IVFT ^ size
How is renal size measured on ultrasound?
Cat: 3.8-4.4 or 3.66±0.46cm
Are the ureters visbale on ultrasound?
- no very difficult/impossible if normal
- urinary jet at ureterovesical junction with doppler exam
How should the prostate appear on ultrasound?
- homogeneous echogenicity (more hyperechoic than surrounding tissues)
- centrally urethra seen
How shoudl the uterus appear on ultrasound?
- tubular structure (large muscularis layer)
- dorsal to urinary bladder
- echogenic line in the midle: collapsed lumen
> may be just a stump left
What contrast study is used to look at kidneys? WHat else is this referred to as?
- excretory urogram OR intravenous pyelogram
> Iodine based dye excretered into urine (no metabolisation before excretion)
Indications for contrast studies
- visualising size/shape/integrity of kidneys and ureters
- qualitative assessment of renal functino (time taken to excrete)
What are positive or negative contrast media?
- = BLACK
+ = WHITE
What are the 2 most common contrast media?
- do not inject!!! GIT or outside animal only
- ionic v non-ionic (ionic drags in water, non-ionic safer less side effects)
Contraindiactions of contrast studies
- dehydration (if stay in contact with nephron for long time can cause damage)
- hypersensitivity to iodine (Very severe)
- heart fialure (give fluids to flush through, may overload to heart failure)
- azotaemia NOT contraindications if adequate hydration provided
Patient preparation before contrast studies
> survey rads
- empty colon with enema
> GA or heavy sedation
> +- pneumocystogram
> Iodine based contrast medium 800mg/kg iV bolus
> Rads at time intervals
- VD @ 0, 2, 5, 10, 15)
- lateral @ 5, 10, 15
- consider oblique views
What are the 3 stages of contrast in the kidneys?
- vascular phase (aorta and renal arteries)
- nephrogram (reaches the renal parencyma)
- pyelogram (renal pelvis and ureters -> bladder)
> excreted within minutes!
What can be identified on contrast study of the kidneys?
- parenchyme v pelvis
- should fill homogenously