Imaging%20of%20the%20Renal%20System

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Imaging of the Renal System

• Dr. Dima Jamjoom
• Department of Radiology

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OUTLINE

• Introduction
• Imaging modalities
• Anatomy
• Cases

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INTRODUCTION

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

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IMAGING MODALITIES

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

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Conventional radiography

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

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Conventional radiography

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

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IVU

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

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IVU

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

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US

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

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US

• Image features
• Operator dependant.
• Projectional image.
• Good resolution.
• Used for stone, hydronephrosis, focal lesion.

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CT

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

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CT

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

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MRI

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

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MRI

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

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Nuclear medicine

• Utilizes a gamma camera and radioactive isotopes.
• Functional test.
• Less expensive.
• Useful for obstruction and split function.

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Nuclear medicine

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

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

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Case (1)

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

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Case (2)

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

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Case (3)

• Elderly male patient with recurrent urinary tract
  infections.

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Case (4)

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

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Case (5)

• Elderly male patient with painless hematuria and
  weight loss.

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Case (6)

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

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Renal trauma grading
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References

• Stephanie Ryan, Anatomy for Diagnostic imaging,
  2nd Edition.
• Jamie Weir, Peter Abraham, Imaging Atlas of
  Human Anatomy 3rd Edition.
• Peter Armstrong, diagnostic imaging,
• 5th Edition.

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THANK YOU