1. CORE Case 7 Workshop Renal and GU

2. Learning Objectives Explain what is Contrast-Induced Nephropathy
List risk factors for Contrast-Induced Nephropathy
Choose which patients with known or suspected urolithiasis should be imaged by CT or US
Describe the imaging findings of nephrolithiasis and urolithiasis on CT and US

3. Learning objectives Describe when imaging is needed in pyelonephritis
Describe the imaging workup for
painless hematuria
Compare and contrast the typical appearance of simple renal cysts and solid renal masses on CT & US

4. What difficulties did you encounter with CORE Case 7?

5. What is Contrast-Induced Nephropathy (CIN)?

6. List risk factors for Contrast-Induced Nephropathy (CIN)

7. What if patient is on Metformin?

8. How can we reduce risk of Contrast-Induced Nephropathy?

9. How can we know who can safely get IV contrast?

10. What are non-contrast CT findings of obstructive ureterolithiasis?

11. Can intrarenal or ureteral stones be seen on CT with IV contrast?

14. 1 hr later

17. 13 months later

18. What are usual complaints in a patient with stone disease (nephroureterolithiasis)? What can mimic stone disease?

21. In suspected urinary stone disease… Who would you image by CT
In suspected urinary stone disease… Who would you image by CT? Who would you image by US? Why?

23. .

25. How can we decrease radiation burden in patients with suspected ureteral stones?

27. What are the Ultrasound findings of nephroureterolithiasis?

28. Superior
Inferior

29. Superior
Inferior
Shadowing

31. Superior
Inferior

32. Superior .
Longitudinal image

33. Patient with recurrent flank pain)

34. Same patient…

35. Same patient…

36. Same patient

39. CECT

40. When is imaging needed in patients with pyelonephritis?

42. What study would you choose in complicated pyelonephritis if the patient is pregnant?

44. What are the findings?

45. List conditions that predispose to Urinary Tract Infection

48. What is a CT urogram? When might we perform one?

49. 1 2 3

50. What are potential causes of hematuria?

51. How do we approach imaging in patients with hematuria?

52. When is imaging workup NOT needed with microscopic hematuria
When is imaging workup NOT needed with microscopic hematuria? What factors guide imaging work up in microscopic hematuria?

55. How do renal simple cysts look on imaging US and CT and MR?

57. Increased Through Transmission
cyst
Increased Through Transmission

61. How do solid renal masses look on imaging?

62. .

67. Cyst Solid mass CT Density CT Enhancement Margin Character
US lesion echo features
US echo features deep to lesion

68. Cyst Solid mass CT Density CT Enhancement Margin Character
Low attenuation
Heterogeneous, near density of renal parenchyma
CT Enhancement
None
Yes, heterogeneous
Margin Character
Smooth
Irregular
US lesion echo features
Anechoic
Mixed echogenicity
US echo features deep to lesion
Enhanced through transmission
Not altered