Imaging of the Imaging of the Renal SystemRenal System

Dr. Reshaid AlJurayyanDepartment of Radiology

OUTLINEOUTLINE

• Introduction• Imaging modalities• Anatomy• Cases

INTRODUCTIONINTRODUCTION

• 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.

IMAGING MODALITIESIMAGING MODALITIES

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

Conventional radiography

• First imaging modality.

• Cheap.• Useful for radio-

opaque stones.

Conventional radiography

Image features:• Projectional image.• Image contrast

determined by tissue density.

• Good evaluation radio-opaque stones.

IVU

• Conventional x-ray plus intravenous contrast.

• Cheap.• Recently replaced

by CT and MRI. • Useful for radio-

opaque stones.

IVU

Image features:• Projectional

image.• Image contrast

determined by tissue density and IV contrast.

• Good evaluation of collecting system and radio-opaque stones.

US

• Use high frequency sound wave.

• Contrast between tissue is determined by sound reflection.

US

Image features:• Operator

dependant.• Projectional

image.• Good resolution.• Used for stone,

hydronephrosis, focal lesion.

CT

• Same basic principle of radiography.

• More precise.• Costly.• +/- contrast.• Useful for

trauma, stone, tumor, infection.

CT

Image features:

• Cross sectional images.

• Image contrast determined by tissue density +/- contrast.

• Better evaluation of soft tissue.

MRI

• Better evaluation of soft tissue.

• Expensive.• Useful for soft

tissue pathology: tumor, infection.

MRI

Image features:• Cross sectional

images.• Image contrast

determine by tissue properties.

• Excellent for soft tissue evaluation.

Nuclear medicine

• Utilizes a gamma camera and radioactive isotopes.

• Functional test.• Less expensive.• Useful for:

obstruction and split function.

Nuclear medicine

Image features:• Projectional image.

• Image contrast by tissue uptake and metabolism.

ANATOMYANATOMY

CASESCASES

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

Case (1)

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

Case (2)

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

Case (3)

• Elderly male patient with recurrent urinary tract infections.

Case (4)

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

Case (5)

• Elderly male patient with painless hematuria and weight loss.

Case (6)

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

Renal trauma grading

THANK YOUTHANK YOU