RADIOLOGY OF THE RENAL SYSTEM DR. Reshaid Aljurayyan DEPARTMENT OF RADIOLOGY

Outline: Introduction Imaging modalities used to study the renal system Anatomy and normal appearance of the renal system Common pathological cases

Introduction What is the radiology? Radiology is a medical specialty that employs the use of imaging to both diagnose and treat disease visualized within the human body. What is the renal system?

Outline: Introduction. Imaging modalities used to study the renal system. Anatomy and normal appearance of the renal system. Common pathological cases.

What are the radiological modalities that can be used to image the renal system ?

Imaging modalities: Conventional X-Ray IVU (intra-venous urogram) / X-Ray + Contrast US CT MRI Nuclear medicine

ALL CAN BE USED Imaging modalities: Conventional X-Ray IVU (intra-venous urogram) / X-Ray + Contrast US CT MRI Nuclear medicine ALL CAN BE USED

Conventional Radiography (X-ray) Cheap & widely available Often used as first choice -ve: Radiation Limited anatomy Used for: Evaluate abdomen pain Some time good for diagnosing kidney stones

Radio lucent  black (air) Radio opaque  white (bone/stone)

Radiograph (X-ray) Where are the kidneys ??

Radiograph (X-ray) Where are the kidneys ??

IVU Same as X ray but with IV contrast

IVU +ve: -ve: Used for: Cheap & available Radiation Needs IV contrast (?reaction) Old (replaced by CT & MRI) Used for: To diagnose kidney stones To diagnose hydronephrosis

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

US + ve: - ve: Used for: Available No radiation Good anatomy Operator dependent Used for: Good for kidney stones Excellent for hydronephrosis Excellent for focal lesion e.g. cysts, masses

Hyper-echoic  white Hypo-echoic  grey An-echoic black (fluid)

CT: + ve: - ve: Used for: Relatively available (more then MRI) Very good anatomy - ve: Radiation Some times need IV contrast (? reaction) Used for: Excellent for kidney stones (the best) Excellent for hydronephrosis & masses Excellent for kidney trauma

Hyper-dense white (stone/bone) Hypo-dense grey to black (fat/fluid)

CT

MRI + ve: - ve: Used for: Excellent anatomy details No radiation Expensive Long scanning time (30 to 60 min) Not used to diagnosed kidney stone Used for: Excellent for masses Good for hydronephrosis

Hyper-intense (white) Hypo-intense (grey to black)

MRI

MRI

Nuclear medicine + ve: - ve: Used for: Excellent to assess function Radiation Poor anatomy details Used for: Evaluated function Evaluated obstruction

Nuclear medicine Image features: Projectional image. Image contrast by tissue uptake and metabolism.

NM

Objectives: Introduction. Imaging modalities used to study the back. Anatomy and normal appearance of the back. Common pathological cases.

Case one: Young male patient presented with left flank pain and hematuria no fever and normal WBC count.

Renal stones

Renal stones

Case two: Middle age women complaining of flank pain , fever and high WBC.

Inflammatory/ infectious

Case three: Old male patient complaining of recurrent renal infection.

Hydronephrosis:

Hydronephrosis:

Case four: Young female presented with decrease renal function (high urea and creatinine level).

Congenital:

Case six: old male patient presented with pain less hematura and weight loss.

Tumor:

Case seven: Young male patient involved in road traffic accident with blunt trauma to the abdomen.

Trauma:

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