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OS 214 - Renal Module - Imaging of The KUB
OS 214 - Renal Module - Imaging of The KUB
Fragante
Imaging of the KUB Exams 1 & 2, Lab Exam
C. Ultrasound
B. Intravenous Pyelography
• Series of films with contrast material to better
visualize the urinary system
• To see if there is retention of urine
D. CT scan
• Has more detail than the other modalities, but more
expensive, of course (see Fig. 38 in appendix).
• Patient is scanned in the supine or decubitus position.
Occasionally, a prone position may prove useful.
• The best images are obtained with the patient’s
respiration suspended; frequently, the end of partial or
full inspiration brings the kidney to better view
• Allows us to see cortex, medulla, and renal drainage
ANATOMICAL ABNORMALITIES Figure 4. Horseshoe kidney (left) and pelvic kidney (right).
A. Ptotic Kidney C. Vesico-ureteral Reflux
• Kidney is descended by at least two vertebrae levels; • Urine goes back (reflux) to the kidneys; patients are
during standing position prone to nephritis
• Prone to having obstruction and infection • Reflux increases risk for infection
• Results in dilatation of the collecting system
B. Hydronephrosis
• There is dilatation of the collecting system because of
a chronic obstruction
• May be uni- or bilateral
• If not treated then there can be infection and then pus
formation
Plain Contrast
Figure 12. Staghorn calculi in both plain and contrast films.
They can occupy a hole collecting system. They conform
to the configuration of the pelvocaceal system.
Ur
Figure 13. Renal calculi as shown in UTS. The stones are
hyperechoic, with shadowing behind them (2011 trans).
PC
Patty, Nina, AD, Aoo : hi Jelly A’s! Hi JollyB’s! =) S
pus/debris
C. Ureteral Stricture
• Stones and inflammation are more common causes
because can lead to fibrosis, leading to stricture
Figure 14. CT-stonogram showing the stones. This is
requested when X-ray is not enough (2011 trans).
Plain Contrast
LM
Figure 19. UTS showing acute renal parenchymal disease.
The areas are hyperechoic because of inflammation.
E. Contracted Bladder
• UB capacity approximately only 20cc; “one drink of
iced tea, ihi na agad”
• Treated with bladder augmentation (2011 trans);
“neobladder”, attached to ileal segment
UB Div
VUR
Figure 26. UB calculi with blood clots, as shown in UTS.
bladder wall (white lining of the UB located in the center), Figure 32. Bladder extrophy. The ureters are dilated, and
as shown in CT scan (right). the symphysis pubis widened.
G. UB Malignancy
• There is a change from “full moon” to “half/crescent
moon”
• UB wall may be eaten up (2011 trans)
• Risk factor: smoking and alcohol intake
• Most common: transitional cell CA
ADRENAL GLANDS
A. Adrenal Gland Hyperplasia
3 min
10 mins
Scout