[08.27] Imaging Patterns of Diseases in the GU Tract V2.pdf

Plain X-ray

Which modality is useful to rule out or rule in various calcifications but cannot usually make a definitive diagnosis?

Fluoroscopy

Which imaging technique involves taking a series of x-rays after the administration of IV contrast?

Intravenous Urography

What does the acronym IVU stand for in genitourinary imaging?

CT urogram

What modern modality has mostly replaced the IVU unless price or availability is a limiting factor?

Scout Film

What is the term for the initial plain x-ray taken before contrast is administered to ensure calcifications are not obscured?

Nephrogram

Which phase of imaging occurs 1 to 2 minutes after contrast administration when the contrast is in the renal parenchyma?

Pyelogram

Which phase occurs about 5 minutes after contrast when it is located in the pelvicalyceal system and ureters?

Ureter stage

What stage occurs 6 to 7 minutes after contrast administration?

20 to 45 minutes

How many minutes post-contrast is the full bladder typically imaged?

Retrograde Pyelogram

In which procedure is a catheter passed through the urethra to inject contrast directly into the distal ureter?

Voiding Cystourethrogram

Which imaging study involves filling the bladder to the point of an urge to void and imaging during urination?

Valve reflux

What specific abnormality involving backflow toward the kidneys is evaluated using a VCUG?

Lateral or extreme posterior oblique

In what positions is a patient typically placed during a VCUG?

Bean shaped

How is the normal shape of a kidney described on an ultrasound?

Isoechoic or hyperechoic

How does a normal kidney typically compare in echogenicity to the liver?

Spleen

Besides the liver, what other organ is used for comparing kidney echogenicity if the liver cannot be used?

Hepatic steatosis or fatty liver

In what clinical condition is the liver a poor comparison for kidney echogenicity?

Echogenic or smaller

How do kidneys appear on ultrasound in cases of parenchymal disease or atrophy?

Dilated or prominent

Under what specific condition can the proximal and middle portions of the ureters be assessed via ultrasound?

Air

What substance within the bowels creates reverberation artifacts and shadows that obscure the ureter on ultrasound?

Anechoic

What term describes the ultrasound appearance of the fluid-filled urinary bladder?

Acoustic window

A full bladder provides what type of viewing benefit for visualizing the uterus or prostate?

Invaginating

How is an enlarged prostate described when it pushes into the bladder on an ultrasound?

Hounsfield Scale

What scale measures the density of materials in a CT scan?

Hounsfield Units

What does the abbreviation HU stand for?

Higher

Does a denser material have a higher or lower HU value?

200 to 1000 HU

What is the important HU range for calcium?

-1000 HU

What is the HU value for air?

-100 HU

What is the HU value for fat?

Emphysematous pyelonephritis

What gas-producing kidney infection is considered a medical emergency?

Angiomyolipoma

Which benign mass contains fat and typically only requires monitoring?

Vehicular trauma

What clinical scenario often involves the assessment of calcium, blood, and metal densities?

+1000 HU

What is the HU value for bone?

40 to 60 HU

What is the HU value for the liver?

-20 to -30 HU

What is the HU value for white matter?

40 HU

What is the HU value for blood?

10 to 40 HU

What is the HU value for muscle?

30 HU

What is the HU value for the kidney?

15 HU

What is the HU value for CSF?

0 HU

What is the reference HU value for water?

-50 to -100 HU

What is the HU value range for fat?

1500 to 1600 HU

The lecturer mentioned seeing calcifications with what exceptionally high HU value?

CT stonogram

What type of plain CT scan is used to check for obstruction in the kidneys and urinary bladder?

Adrenals

What is the most superior structure typically seen in a CT stonogram?

Unenhanced

In which phase of contrast-enhanced CT urography are no structures yet highlighted?

Nephrogram

In which CT phase is the nephron enhanced?

Corticomedullary

In which CT phase is contrast seen specifically between the cortices and medullary pyramids?

Pyelogram

In which CT phase is contrast found in the collecting structures?

Soft tissue contrast

MRI provides superior contrast for what type of tissue?

Hypointense

How do the kidneys appear in a T1-weighted MRI?

Hyperintense

How do the kidneys appear in a T2-weighted MRI?

Fat saturation

What specific MRI request is used to suppress fat and differentiate it from soft tissue?

Angiography

Which modality gives a good view of blood vessels and is used in cases of renal artery stenosis?

Inferior vena cava

Into which vessel does the renal venous drainage flow?

Renal transplant

In which surgical scenario must the surgeon know the vascular anatomy and anomalies of the donor and recipient?

Conventional angiography

Which procedure involves inserting contrast in real-time in a catheterization lab to visualize vessels?

Duplicate

What can the renal artery sometimes do, with one branch from the IVC and one from the iliac?

Renal agenesis

What is the medical term for an absent kidney?

Unilateral

Is renal agenesis more commonly unilateral or bilateral?

Adrenal gland

An absent kidney is likely to also have an absent what on the same side?

Supernumerary kidney

What is the term for having an extra kidney?

Left common iliac artery

In the source image, from which vessel did the ectopic artery for the supernumerary kidney originate?

Two

How many renal arteries are seen supplying a supernumerary kidney in the provided CT reconstruction?

Malrotated kidney

What is an anatomic variation in the position of the kidney specifically related to anomalous hilum orientation?

Anteromedially

In what direction should a normal renal hilum face?

Anterolaterally

In what direction does an abnormally rotated renal hilum face?

90 degrees

Normally, the kidneys rotate how many degrees along their longitudinal axis during ascent?

Incomplete rotation

What is the most common form of malrotation where the hilum faces anteriorly and the ureter is lateral?

Excessive rotation

What form of malrotation occurs when the hilum and vessels are posterior?

Reverse rotation

What form of malrotation occurs when the hilum is lateral and the vessels are anterior?

Ectopic kidney

What results from any arrest in the migration of kidneys during embryological development?

Pelvic

What is the most common location for an ectopic kidney?

Iliac crests

At what anatomical level is a pelvic ectopic kidney typically found?

Intrathoracic

Which ectopic kidney location is caused by overshooting during development?

Diaphragmatic hernia

What cause is associated with the presence of an intrathoracic kidney?

Horseshoe kidney

What is the most common type of renal fusion anomaly?

Inferior poles

Which specific part of the kidneys fuse to form a horseshoe kidney?

Aorta

Horseshoe kidneys are typically bridge anterior to which major vessel?

Inferior Mesenteric Artery

What specific artery stops the normal ascent of a horseshoe kidney?

Trauma and infection

Horseshoe kidneys are particularly susceptible to which two complications?

Pancake kidney

What rare fusion anomaly involves kidneys that are ectopic and fused at both the upper and lower poles?

Crossed fused ectopy

What is the condition where one kidney crosses to the opposite side and fuses with the other?

9 to 12 cm

What is the normal length range for an adult kidney?

0.8 cm

What is the normal measurement for adult cortical thickness?

Medulla

If the renal cortex is thinner than 0.5 cm, there is a possibility of hitting what during a biopsy?

0.6 cm

What is considered the ideal ample thickness for a renal cortex?

Bilateral small kidneys

What size abnormality implies a systemic disease process injuring both kidneys?

Nephrosclerosis

Which cause of bilateral small kidneys results from systemic hypertension?

Chronic uremic disease

What condition, common in dialysis patients, presents with small kidneys containing numerous cysts?

8 years

How many years had the patient in Figure 34 been on hemodialysis?

Global damage from a focal process

What causes a unilateral small kidney?

Renal artery stenosis

Which differential for a unilateral small kidney involves narrowing of the blood supply?

Post obstructive atrophy

What cause of a unilateral small kidney follows a long-term blockage?

Bilateral large kidneys

What size abnormality is mostly due to systemic processes like cell infiltration or protein deposition?

Leukemia and lymphoma

Name two cell infiltration disorders that cause bilaterally large kidneys.

Amyloidosis

What protein deposition disorder causes bilaterally large kidneys?

Adult Polycystic Kidney Disease

What common hereditary condition causes bilaterally enlarged kidneys with multiple cysts?

Hepatic cysts

Adult Polycystic Kidney Disease is usually associated with cysts in what other organ?

Duplicated collecting system

What is a primary differential for a unilateral enlarged kidney that features two pelves?

Acute pyelonephritis

Which inflammatory condition results in enlargement of the kidney due to infection?