Urinary tract

Published on 01/04/2015 by admin

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Last modified 01/04/2015

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Chapter 5 Urinary tract

Excretion Urography

Also known as intravenous urography (IVU). The technique is much less frequently used than in the past, being largely replaced by CT, MRI or US.

Contraindications

See Chapter 2 – general contraindications to intravenous (i.v.) water-soluble contrast media and ionizing radiation. Pre-medication with steroids (see Chapter 2) may be considered but information regarding the renal size, presence of calcification and pelvicalyceal systems may be gained by using a combination of plain film, US, unenhanced CT and MRI.

Films

ULTRASOUND OF THE URINARY TRACT IN ADULTS

ULTRASOUND OF THE URINARY TRACT IN CHILDREN

The availability of high-resolution real-time US has revolutionized the investigation of paediatric renal disease. It demonstrates anatomy without the necessity for adequate renal function but, because it gives no functional information, it is the ideal complement to nuclear medicine imaging. It should be stressed that the technique is only as good as the effort put in to obtain the images.

Indications (after Lebowitz, 1985)1

When assessing possible renal disease by ultrasonography, a number of normal ‘variants’ may be confused with disease. These include increased parenchymal echogenicity in the neonatal period, echo-poor papillae which may mimic dilated calyces and persistent fetal lobulation, hepatic and splenic impressions, and parenchymal junctional lines, which may mimic scarring.

Computed Tomography of the Urinary Tract

Magnetic Resonance Imaging of the Urinary Tract

MAGNETIC RESONANCE UROGRAPHY

The two most common MR urographic techniques are:

In and out of phase T1-weighted gradient echo scans can be performed to characterize adrenal mass lesions or identify lipid within angiomyolipomas and clear cell carcinoma of the kidney.

Technique

Magnetic Resonance Imaging of the Prostate

Technique

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