Radiology of the Urinary System Flashcards

1
Q

Are mens and womans kidneys the same size?

A

Kidneys are slightly larger in men than woman

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2
Q

How does kidney size change throughout life?

A

They increase in size up to age 20 and become smaller again in later life

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3
Q

What is renal blood flow in cc/min?

A

1200cc/min

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4
Q

How long is each kidney?

A

10-12cm

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5
Q

How long and wide are the ureters?

A
  • 25-30cm long
  • 3-8mm in diameter
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6
Q

What are the 3 points of narrowing in the ureters?

A
  • PUJ
  • Pelvic brim
  • VU junction
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7
Q

How is the bladder peritonised?

A

Extra-peritoneal

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8
Q

What are indications for renal imaging?

A
  • Renal colic and renal stone disease
  • Haematuria
  • Suspected renal mass
  • UTIs
  • Hypertension
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9
Q

What are some different imaging techniques for the urinary system?

A
  • Plain film
    • Advantages
      • Cheap and readily available
      • Functional and anatomical information (IVU)
    • Disadvantages
      • Low sensitivity and specificity for urological diseases
      • Radiation
  • Contrast studies
    • IVU
    • Pyelography
      • Injection of contrast into the ureters
      • Antegrade, retrograde, ileal conduit
    • Cystography
    • Micturating cystourethrography
      • Vesico-ureteric reflux and its grade
  • Ultrasound with or without contrast
    • Advantages
      • Cheap and readily available
      • No radiation
      • Contrast is not nephrotoxic
      • Real time imaging
    • Disadvantages
      • Limited by body habitus and gas
      • Poor visualisation of ureters
      • Operator dependant
      • No functional information
  • CT and CTU
    • Advantages
      • Currently imaging modality of choice for detection of renal stones, staging renal tumours, investigation of haematuria
      • Good spatial resolution with capability of multi planar reformat
    • Disadvantages
      • Radiation dose
      • Cost
      • Contrast resolution less than MR
      • Contrast reaction and nephrotoxicity
  • MR and MRU
    • Advantages
      • Multiplanar imaging
      • Excellent contrast resolution
      • Imaging of urothelium without contrast injection (MRU)
    • Disadvantages
      • Poor spatial resolution
      • Poor detection of calcification and stones
      • Cost
      • Contraindications
        • Pace maker, claustrophobia etc
      • Contrast reaction and other side effects
  • Isotope scans
    • Different kinds
      • DMSA
        • To look for renal scaring
      • MAG3
        • Asses renal function and drainage
      • Bone scan
        • Metastatic disease such as prostate cancer
  • PET-CT
    • Limited use in staging of urological malignancies due to high uptake in urine and variable uptake by tumours
    • May be useful for extra-urological metastatic disease if other imaging modalities are equivocal or in poor surgical candidates
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10
Q

What are advantages of plain film imaging?

A
  • Cheap and readily available
  • Functional and anatomical information (IVU)
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11
Q

What are disadvantages of plain film imaging?

A
  • Low sensitivity and specificity for urological diseases
  • Radiation
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12
Q

What are examples of renal contrast studies?

A
  • IVU
  • Pyelography
    • Injection of contrast into the ureters
    • Antegrade, retrograde, ileal conduit
  • Cystography
  • Micturating cystourethrography
    • Vesico-ureteric reflux and its grade
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13
Q

What is pyelography?

A

Form of imaging of the renal pelvis and ureter, can do a intravenous pyelogram – In which a contrast solution is introduced through a vein into the circulatory system

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14
Q

What is a cystography?

A

Imaging test that can help diagnose problems in your bladder. It uses X-rays.

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15
Q

What is micturating cystourethrography?

A

Technique for visualizing a person’s urethra and urinary bladder while the person urinates

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16
Q

What are advantages of ultrasound with contrast?

A
  • Cheap and readily available
  • No radiation
  • Contrast is not nephrotoxic
  • Real time imaging
17
Q

What are disadvantages of ultrasound with contrast?

A
  • Limited by body habitus and gas
  • Poor visualisation of ureters
  • Operator dependant
  • No functional information
18
Q

What are advantages for CT and CTU?

A
  • Currently imaging modality of choice for detection of renal stones, staging renal tumours, investigation of haematuria
  • Good spatial resolution with capability of multi planar reformat
19
Q

What are disadvantages for CT and CTU?

A
  • Radiation dose
  • Cost
  • Contrast resolution less than MR
  • Contrast reaction and nephrotoxicity
20
Q

What does CTU stand for?

A

CT urography

21
Q

What is urography?

A

Another term for pyelography

22
Q

What are advantages of MR and MRU?

A
  • Multiplanar imaging
  • Excellent contrast resolution
  • Imaging of urothelium without contrast injection (MRU)
23
Q

What are disadvantages of MR and MRU?

A
  • Poor spatial resolution
  • Poor detection of calcification and stones
  • Cost
  • Contraindications
    • Pace maker, claustrophobia etc
  • Contrast reaction and other side effects
24
Q

What are contraindications for MR and MRU?

A
  • Pace maker, claustrophobia etc
25
Q

What are different kinds of renal isotope scans?

A
  • DMSA
    • To look for renal scaring
  • MAG3
    • Asses renal function and drainage
  • Bone scan
    • Metastatic disease such as prostate cancer
26
Q

What is DMSA used for?

A
  • To look for renal scaring
27
Q

What is MAG3 used for?

A
  • Asses renal function and drainage
28
Q

What is a bone scan used for?

A
  • Metastatic disease such as prostate cancer
29
Q

What is a urinary PET-CT used for?

A
  • Limited use in staging of urological malignancies due to high uptake in urine and variable uptake by tumours
  • May be useful for extra-urological metastatic disease if other imaging modalities are equivocal or in poor surgical candidates