Imaging of the Renal System..........ppt
- 1. Imaging of the Renal System Dr. Reshaid Al Jurayyan Department of Radiology
- 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. • Disadvantage : radiation
- 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. • Disadvantage : impaired the kidney
- 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. • No radiation • 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. • Best in stones
- 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
- 32. •MRI IS NOT GOOD IN STONES •In MRI bones are black
- 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. • Kidney stones with hydronephrosis. • X-ray >> US >> CT
- 40. Case (2) • Middle aged woman presenting with flank pain, fever and high WBC. • Inflammation (e.g. Pyelonephritis) •US >> CT+contrast >> MRI
- 42. Case (3) • Elderly male patient with recurrent urinary tract infections. • Bilateral hydronephrosis due to Prostate enlargement. • US
- 45. Case (4) • Young female presenting with decreased renal function (high urea and creatinine level). • Polycystic. • US >> CT >> MRI • Contrast is contraindicated
- 48. Case (5) • Elderly male patient with painless hematuria and weight loss. • Tumor • MRI (BEST) >> US >> CT+contrast
- 50. Case (6) • Young male patient involved in a motor vehicle accident with blunt trauma to the abdomen. • Truma • CT (because it’s very fast)
- 53. • األسئلة عن الدكتور سألت : األسئلة تكون راح يقول وبتكون بالنظري جاه واحد مثال حادث أشعة افضل وش هذا؟ للشيء األجهزة خاصية وكذلك البريدي حمد
- 54. THANK YOU
Editor's Notes
- #19: hydronephrosis : dilation in the calyces