RADIOLOGY OF THE RENAL SYSTEM

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

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

3. 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?

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

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

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

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

8. 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

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

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

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

12. IVU • Same as X ray but with IV contrast

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

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

16. 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

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

19. 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

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

23. CT

24. 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

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

26. MRI

27. MRI

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

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

30. NM

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

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

33. Renal stones

34. Renal stones

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

36. Inflammatory/ infectious

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

38. Hydronephrosis:

39. Hydronephrosis:

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

41. Congenital:

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

43. Tumor:

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

45. Trauma:

46. THANK YOU