Key Diagnostic Features in Uroradiology: A Case-Based Guide
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This book presents a wealth of images of the different diseases and conditions encountered in the field of uroradiology with the aim of enabling the reader to recognize lesions, to interpret them appropriately and to make correct diagnoses. The images have been selected because they depict typical or classic findings and provide a route to lesion recognition that is superior to memorization of descriptions. The imaging modalities represented include CT, CT angiography, CT urography, MRI, MRA, MRU, diffusion-weighted MRI and ADC mapping, dynamic contrast-enhanced MRI, sonography, conventional angiography, excretory urography, retrograde pyelography, cystography, urethrography and voiding cystourethrography. For each depicted case, important imaging features are highlighted and key points identified in brief accompanying descriptions. Readers will find that the book provides excellent guidance in the selection of imaging modalities and facilitates diagnosis. It will be an ideal ready source of information on key imaging features of urinary tract diseases for medical students, residents, fellows and physicians handling these diseases.
left renal pelvis, similar to that shown on RP. Figure 1.9b, axial enhanced CT image of excretory phase shows the left renal pelvis (arrow) anterior to the left renal calyces, indicating malrotation of the right renal axis. Figure 1.10, an axial T2-weighted MRI image shows similar anterior positioning of the left renal pelvis, as depicted on Fig. 1.9b. 1.4 Malrotation of the Renal Axis 9 a Fig. 1.10 Key Diagnostic Features Malrotation of the renal axis is considered when the renal pelvis
urography. The ureter from upper moiety is associated with ectopic insertion, ureterocele, and stenosis at the distal end, while the ureter in lower moiety is associated with vesicoureteral reflux. 18 1 1.9 Normal Variant and Congenital Anomalies Ectopic Ureter Insertion to the Vagina Case 14 a b c d Fig. 1.23 Enhanced computed tomography (CT) images show an ectopic ureter insertion to the vagina with obstruction of a patient with duplex ureters. Figure 1.23a, enhanced CT image at
low-density area involvements by acute pyelonephritis on enhanced CT or MRI. Acute pyelonephritis may involve one or both kidneys. Other common associated findings of acute pyelonephritis include renal swelling and dirty ipsilateral perinephric fat or fluid. In severe infection of acute pyelonephritis, the involved kidney could have a delayed hemodynamics and nephrogram. At follow-up images, the infected site of renal parenchyma shows renal scarring appearance. Main Differential Diagnoses Key
inside the renal collecting system. Therefore, computed tomography is a much sensitive imaging tool for detecting the presence of air collections inside the lumen of the renal collecting system than plain radiographs of the kidney, ureter, and bladder (KUB), especially in small amounts of abnormal air. The presence of air in the renal collecting system could be due to prior instrumentation or interventions, such as retrograde pyelography (RP), antegrade pyelography (AP), percutaneous nephrostomy,
Renal Cystic Masses of Bosniak’s Category IV Case 10 a b c Fig. 3.15 Renal computed tomography (CT) shows a Bosniak IV cystic mass, proved as cystic renal cell carcinoma (RCC). Unenhanced axial (Fig. 3.15a), enhanced axial (Fig. 3.15b), and enhanced coronal (Fig. 3.15c) CT images show a cystic mass (arrow) with obvious enhancing soft tissue part of the right renal lower pole, suggestive of a Bosniak IV cystic mass. Cystic RCC is considered on CT. 108 3 Renal Cystic Disease Case 11 a b