1. Urinary Tract Radiological Investigations and Anatomy
MEDICAL IMAGING & RADIOLOGY DEPARTMENT

2. IMAGING MODALITIES IONIZING RADIATION NONIONIZING RADIATION
Conventional (plain) radiography.
Contrast studies (X-Ray + Contrast)
Computed Tomography.
Isotopic scan
Angiography
NONIONIZING RADIATION
US.
MRI.
Intravenous urography
Cysto-urethography
Antegrade pyelography
Retrograde pyelography
Hysterosalpingography

3. KUB KIDNEYS URETERS URINARY BLADDER URETHRA
Conventional plain film of the abdomen is called a KUB (Kidneys, Ureters, Bladder)
KIDNEYS
URETERS
URINARY BLADDER
URETHRA
Good evaluation of radio-opaque stones

4. This is KUB taken post intravenous contrast injection
IVU
This is KUB taken post intravenous contrast injection
KUB
IVU

5. This is KUB taken post intravenous contrast injection
IVU
This is KUB taken post intravenous contrast injection
Also called IVP (intravenous pyelogram)
Demonstrates both function and structure of the renal system
Function --- Filtration
Structure --- Contrast filled collecting system
Indications:
Urolithiasis / calculus
Pyelonephritis
Hydronephrosis
Trauma
Tumour
Renal hypertension
Congenital abnormality
Contra-Indications: (relative)
History of Allergy
Asthma
Cardiovascular disease
Sickle cell disease
Diabetes mellitus

6. This is KUB taken post intravenous contrast injection
IVU
This is KUB taken post intravenous contrast injection
Renal Pelvis
After IV injection, sequential images are taken in time order.
Immediate post IV
5 min post IV
10 min post IV
Left Ureter
Urinary Bladder

7. This is KUB taken post intravenous contrast injection
IVU
This is KUB taken post intravenous contrast injection
Immediate post IV is nephrogram
Left Kidney
Right Kidney

8. This is KUB taken post intravenous contrast injection
IVU
This is KUB taken post intravenous contrast injection
5 min post IV is nephrogram

9. This is KUB taken post intravenous contrast injection
IVU
This is KUB taken post intravenous contrast injection
10 min post IV is nephrogram
Renal Pelvis
Left Ureter
Full Bladder
20 min
Urinary Bladder

10. Kidney Renal fascia Hilum Renal sinus Renal cortex Renal medulla
Renal columns
Renal medulla
Renal pyramids
Calyces
Minor calyces
Major calyces
Renal pelvis

11. COMPUTED TOMOGRAPHY Non-contrast Arterial = Cortical Venous
= Parenchymal
Excretion

12. RENALUS

15. RENAL MRI

16. Case one
A 29 year old female patient presented to the emergency department complaining of acute sudden severe right flank pain radiated to the groin for 1 hour associated with hematuria.
What is the likely diagnosis?
What investigation you will request?
What are the findings you expect to see?

17. Renal tract stone

18. Renal tract stone:

19. Renal tract stone

20. Renal tract stone:

21. Urinary tract stone

22. Case Two
A 36 year old male patient involved in road traffic accident. On examination patient is conscious oriented and in pain. Abdominal examination revealed diffuse guarding and tenderness.
What is the likely diagnosis?
What investigation you will request?
What are the findings you expect to see?

25. Case Three
A 54 years old female patient known case of diabetes and hypertension found to have high creatinine level.
What is the likely diagnosis?
What investigation you will request?
What are the findings you expect to see?

26. Hydronephrosis

27. Hydronephrosis

28. Case Four
A 49 years old male patient smoker for 30 years. Presented to primary health case with complaint of hematuria and weight loss. Patient denied history of flank or pelvic pain.
What is the likely diagnosis?
What investigation you will request?
What are the findings you expect to see?

29. Renal cell tumor

30. Renal cell tumor

31. Transitional cell tumor

32. Renal cysts

33. polycystic kidney disease

34. Horseshoe kidney

35. Cross Ectopic Kidney

36. THANK YOU