Imaging of the Renal System

1
Imaging of the Renal System

• Dr. Reshaid Al Jurayyan
• Department of Radiology

2
OUTLINE

• Introduction
• Imaging modalities
• Anatomy
• Case scenarios

3
Case (1)

• Young male patient presenting with left flank
  pain and hematuria, no fever and normal WBC count.

4
Case (2)

• Middle aged woman presenting with flank pain,
  fever and high WBC.

5
Case (3)

• Elderly male patient with recurrent urinary tract
  infections.

6
Case (4)

• Young female presenting with decreased renal
  function (high urea and creatinine level).

7
Case (5)

• Elderly male patient with painless hematuria and
  weight loss.

8
Case (6)

• Young male patient involved in a motor vehicle
  accident with sever blunt trauma to the abdomen.

9
INTRODUCTION

• What is radiology?
• It is a medical specialty that employs the use
  of imaging to both diagnosing and treating
  diseases within the human body.
• What is the renal system?
• Kidneys, ureters, urinary bladder and urethra.

10
What radiological modalities can be used to image
the renal system ?
11
IMAGING MODALITIES

• Conventional radiography
• Intravenous urogram (IVU)
• US
• CT
• MRI
• Nuclear medicine

12
Terminology

• X ray Radio-opaque (white) vs radio-lucent
  (black)
• US Hyper-echoic (white) / hypo-echoic(black)
• CT Hyper-dense (white) / hypo-dense(black)
• MRI Hyper-signal (white) / hypo-signal
• Nuclear med. Highuptake(black) / lowuptake
  (white)

13
Conventional radiography

• First imaging modality in most cases.
• Cheap.
• Useful for radio-opaque stones.

14
Conventional radiography

• Image features
• Projectional image.
• Image contrast determined by tissue density.
• Good evaluation radio-opaque stones.

15
IVU

• Conventional x-ray plus intravenous contrast.
• Cheap.
• Recently replaced by CT and MRI.
• Useful for radio-opaque stones.

16
IVU

• Image features
• Projectional image.
• Image contrast determined by tissue density and
  IV contrast.
• Good evaluation of collecting system and
  radio-opaque stones.

17
US

• Use high frequency sound wave.
• Contrast between tissue is determined by sound
  reflection.

18
US

• Image features
• Operator dependant.
• Good resolution.
• Used for stone, hydronephrosis, focal lesion (ex.
  masses).

19
CT

• Same basic principle of radiography.
• More precise.
• Costly.
• /- IV contrast.
• Useful for trauma, stone, tumor, infection.

20
CT

• Image features
• Cross sectional images.
• Image contrast determined by tissue density /-
  contrast.
• Better evaluation of soft tissue.

21
MRI

• Better evaluation of soft tissue.
• Expensive.
• Useful for soft tissue pathology tumor,
  infection.

22
MRI

• Image features
• Cross sectional images.
• Image contrast determine by tissue properties.
• Excellent for soft tissue evaluation.

23
Nuclear medicine

• Utilizes a gamma camera and radioactive isotopes.
• Good to assess kidney function.
• Less expensive.

24
Nuclear medicine

• Image features
• Projectional image.
• Image contrast by tissue uptake and metabolism.

25
ANATOMY
26
(No Transcript)
27
(No Transcript)
28
(No Transcript)
29
(No Transcript)
30
(No Transcript)
31
(No Transcript)
32
(No Transcript)
33
(No Transcript)
34
(No Transcript)
35
CASES
36

• What are the imaging modalities?
• What are the findings?
• Diagnosis?

37
Case (1)

• Young male patient presenting with left flank
  pain and hematuria, no fever and normal WBC count.

38
(No Transcript)
39
(No Transcript)
40
Case (2)

• Middle aged woman presenting with flank pain,
  fever and high WBC.

41
(No Transcript)
42
Case (3)

• Elderly male patient with recurrent urinary tract
  infections.

43
(No Transcript)
44
(No Transcript)
45
Case (4)

• Young female presenting with decreased renal
  function (high urea and creatinine level).

46
(No Transcript)
47
(No Transcript)
48
Case (5)

• Elderly male patient with painless hematuria and
  weight loss.

49
(No Transcript)
50
Case (6)

• Young male patient involved in a motor vehicle
  accident with blunt trauma to the abdomen.

51
(No Transcript)
52
Renal trauma grading
53
THANK YOU