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DU PA Neph imaging

Duke PA Nephrology Imaging

QuestionAnswer
Abdominal Radiograph or aka __ KUB
Abdominal Radiograph is used for __ evaluat bowel obstruction, detect free intraperitoneal gas, follow up of chronic renal calculi
tomograph focused, moving planar x-ray source
When do you do a retrograde pyelogram when intravenous pyelograph fails
when do you used caution with radiographic imaging in children and pregnant women
indications for renal ultrasound urinary obstruction, follow-up renal transplant complications, image guided biopsy
indication for renal scintigrophy evaluate renal function
indications for cystogram/voiding cystourethrogram suspected vesicoureteral reflux, post surgery/post traumatic complications
the biggest benifit to cystoscopy the urologist can visualize and intervene at the same time
with CT, if you are specifically looking for renal stones __ don't use contrast
indications fro MRI Renal mass characterization, Renal Transplants, Renal Artery Stenosis, Pediatrics, Pregnant women
Imaging modality of choice for initial assessment of renal masses, cysts CT, US(cystic masses)
Imaging modality of choice for initial assessment of acute renal or ureteral calculi CT
Imaging modality of choice for initial assessment of chronic renal or ureteral calculi radiograph
Imaging modality of choice for initial assessment of renal trauma CT
When is imaging appropriate in adults with urinary tract infection Stones or obstruction suspected, Frequent or recurrent UTI, Diagnosis is in doubt or complication suspected
when is imaging appropriate in kids with UTI Imaging probably worthwhile with first febrile UTI if: 1) Pt has questionable follow-up, 2) Does not respond promptly to tx (febrile > 72 h), 3) Persistently abnormal voiding pattern (dribbling),4) Abdominal mass
some calculi may not be visible on radiographs, but almost all are seen on CT
50% of __ are found incidentally on imaging for other reasons renal cell carcinoma
classical appearance of renal cell carcinoma Hypervascular renal cortical mass; heterogeneous, enhancing, multilobular; hemorrhage and necrosis; coarse Ca2+ Mets to lungs, mediastinum, liver, and bone (lytic)
pediatric vesicoureteral reflux Retrograde flow of urine from bladderPredisposes to recurrent infection or renal scarringSome outgrow; others require surgery
indications for iodine-based contrast Opacify blood vessels, organs, GU tract for radiation-based modalities (CT, IVP)
risks of iodine-based contrast allergy, nephrotoxicity
gadolinium-based contrast is used for MRI
indication for gadolinium-based contrast opacify blood vessels and organs for MRI
Risks for gadolinium-based contrast nephrogenic systemic fibrosis, unkown effects on fetus, allergies are extraordinarily rare
spiral CT without contrast is the same thing as stone protocol CT
something that has high attenuation shows up __ on CT white
stones and bones have high __ attenuation
Created by: bwyche
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