• IONIZING RADIATION
Conventional (plain) radiography.
Contrast studies (X-Ray + Contrast)•
Computed Tomography.
Isotopic scan
Angiography
• NONIONIZING RADIATION
US.
MRI.
•
•
•
•
Intravenous urography
Cysto-urethography
Antegrade pyelography
Retrograde pyelography
Hysterosalpingography
Conventional plain film of the abdomen is called a KUB
(Kidneys, Ureters, Bladder)
KIDNEYS
URETERS
URINARY
BLADDER
URETHRA
Good evaluation of radio-opaque stones
This is KUB taken post intravenous contrast injection
KUB
IVU
This is KUB taken post intravenous contrast injection
Also called IVP (intravenous pyelogram)
Demonstrates both function and structure of the renal system
•Function --- Filtration
•Structure --- Contrast filled collecting system
Indications:
Contra-Indications: (relative)
•Urolithiasis / calculus
•Pyelonephritis
•Hydronephrosis
•Trauma
•Tumour
•Renal hypertension
•Congenital abnormality
•History of Allergy
•Asthma
•Cardiovascular disease
•Sickle cell disease
•Diabetes mellitus
This is KUB taken post intravenous contrast injection
Renal Pelvis
•
After
IV
injection,
sequential images are
taken in time order.
•
Immediate post IV
•
5 min post IV
•
10 min post IV
Left Ureter
Urinary Bladder
This is KUB taken post intravenous contrast injection
•
Right Kidney
Immediate post IV is nephrogram
Left Kidney
This is KUB taken post intravenous contrast injection
•
5 min post IV is nephrogram
This is KUB taken post intravenous contrast injection
•
10 min post IV is nephrogram
Renal Pelvis
Left Ureter
Full Bladder
20 min
Urinary Bladder
Kidney
•
•
•
•
Renal fascia
Hilum
Renal sinus
Renal cortex
– Renal columns
• Renal medulla
– Renal pyramids
• Calyces
– Minor calyces
– Major calyces
– Renal pelvis
Non-contrast
Venous = Parenchymal
Arterial = Cortical
Excretion
Case one
A 29 year old female patient presented to the
emergency department complaining of acute
sudden severe right flank pain radiated to the groin
for 1 hour associated with hematuria.
• What is the likely diagnosis?
• What investigation you will request?
• What are the findings you expect to see?
Renal tract stone
Renal tract stone:
Renal tract stone
Renal tract stone:
Urinary tract stone
Case Two
A 36 year old male patient involved in road traffic
accident. On examination patient is conscious
oriented and in pain. Abdominal examination
revealed diffuse guarding and tenderness.
What is the likely diagnosis?
What investigation you will request?
What are the findings you expect to see?
Case Three
A 54 years old female patient known case of
diabetes and hypertension found to have high
creatinine level.
What is the likely diagnosis?
What investigation you will request?
What are the findings you expect to see?
Hydronephrosis
Hydronephrosis
Case Four
A 49 years old male patient smoker for 30 years.
Presented to primary health case with complaint
of hematuria and weight loss. Patient denied
history of flank or pelvic pain.
What is the likely diagnosis?
What investigation you will request?
What are the findings you expect to see?
Renal cell tumor
Renal cell tumor
Transitional cell tumor
Renal cysts
polycystic kidney disease
Horseshoe kidney
Cross Ectopic Kidney