RADIOLOGY OF THE RENAL SYSTEM

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RADIOLOGY OF THE RENAL SYSTEM

• DR. Reshaid Aljurayyan
• DEPARTMENT OF RADIOLOGY

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Outline

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

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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?

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Outline

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

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

• Conventional X-Ray
• IVU (intra-venous urogram) / X-Ray Contrast
• US
• CT
• MRI
• Nuclear medicine

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Imaging modalities

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

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Conventional Radiography (X-ray)

• ve
• Cheap widely available
• Often used as first choice
• -ve
• Radiation
• Limited anatomy
• Used for
• Evaluate abdomen pain
• Some time good for diagnosing kidney stones

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• Radio lucent ? black (air)
• Radio opaque ? white (bone/stone)

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

• Same as X ray but with IV contrast

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IVU

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

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US

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

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US

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

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• Hyper-echoic ? white
• Hypo-echoic ? grey
• An-echoic? black (fluid)

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CT

• ve
• 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

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

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CT
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MRI

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

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

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MRI
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MRI
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Nuclear medicine

• ve
• Excellent to assess function
• - ve
• Radiation
• Poor anatomy details
• Used for
• Evaluated function
• Evaluated obstruction

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Nuclear medicine

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

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NM
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Objectives

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

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Case one

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

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Renal stones
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Renal stones
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Case two

• Middle age women complaining of flank pain ,
  fever and high WBC.

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Inflammatory/ infectious
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Case three

• Old male patient complaining of recurrent renal
  infection.

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Hydronephrosis
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Hydronephrosis
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Case four

• Young female presented with decrease renal
  function (high urea and creatinine level).

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Congenital
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Case six

• old male patient presented with pain less
  hematura and weight loss.

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Tumor
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Case seven

• Young male patient involved in road traffic
  accident with blunt trauma to the abdomen.

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Trauma
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THANK YOU