1. RADIOLOGY OF THE RENAL SYSTEM
DR. Reshaid Aljurayyan
DEPARTMENT OF RADIOLOGY

2. Outline: Introduction
Imaging modalities used to study the renal system
Anatomy and normal appearance of the renal system
Common pathological cases

3. Introduction What is the radiology?
Radiology is a medical specialty that employs the use of imaging to both diagnose and treat disease visualized within the human body.
What is the renal system?

4. Outline: Introduction.
Imaging modalities used to study the renal system.
Anatomy and normal appearance of the renal system.
Common pathological cases.

5. What are the radiological modalities that can be used to image the renal system ?

6. Imaging modalities: Conventional X-Ray
IVU (intra-venous urogram) / X-Ray + Contrast US CT
MRI
Nuclear medicine

7. ALL CAN BE USED Imaging modalities: Conventional X-Ray
IVU (intra-venous urogram) / X-Ray + Contrast US CT
MRI
Nuclear medicine
ALL CAN BE USED

8. Conventional Radiography (X-ray)
Cheap & widely available
Often used as first choice
-ve:
Radiation
Limited anatomy
Used for:
Evaluate abdomen pain
Some time good for diagnosing kidney stones

9. Radio lucent  black (air)
Radio opaque  white (bone/stone)

10. Radiograph (X-ray)
Where are the kidneys ??

11. Radiograph (X-ray)
Where are the kidneys ??

12. IVU
Same as X ray but with IV contrast

13. IVU +ve: -ve: Used for: Cheap & available Radiation
Needs IV contrast (?reaction)
Old (replaced by CT & MRI)
Used for:
To diagnose kidney stones
To diagnose hydronephrosis

15. US Ultrasound. Use high frequency sound wave.
Contrast between tissue is determined by sound reflection.

16. US + ve: - ve: Used for: Available No radiation Good anatomy
Operator dependent
Used for:
Good for kidney stones
Excellent for hydronephrosis
Excellent for focal lesion e.g. cysts, masses

17. Hyper-echoic  white
Hypo-echoic  grey
An-echoic black (fluid)

19. CT: + ve: - ve: Used for: Relatively available (more then MRI)
Very good anatomy
- ve:
Radiation
Some times need IV contrast (? reaction)
Used for:
Excellent for kidney stones (the best)
Excellent for hydronephrosis & masses
Excellent for kidney trauma

20. Hyper-dense white (stone/bone)
Hypo-dense grey to black (fat/fluid)

23. CT

24. MRI + ve: - ve: Used for: Excellent anatomy details No radiation
Expensive
Long scanning time (30 to 60 min)
Not used to diagnosed kidney stone
Used for:
Excellent for masses
Good for hydronephrosis

25. Hyper-intense (white)
Hypo-intense (grey to black)

26. MRI

27. MRI

28. Nuclear medicine + ve: - ve: Used for: Excellent to assess function
Radiation
Poor anatomy details
Used for:
Evaluated function
Evaluated obstruction

29. Nuclear medicine Image features: Projectional image.
Image contrast by tissue uptake and metabolism.

30. NM

31. Objectives: Introduction. Imaging modalities used to study the back.
Anatomy and normal appearance of the back.
Common pathological cases.

32. Case one:
Young male patient presented with left flank pain and hematuria no fever and normal WBC count.

33. Renal stones

34. Renal stones

35. Case two:
Middle age women complaining of flank pain , fever and high WBC.

36. Inflammatory/ infectious

37. Case three:
Old male patient complaining of recurrent renal infection.

38. Hydronephrosis:

39. Hydronephrosis:

40. Case four:
Young female presented with decrease renal function (high urea and creatinine level).

41. Congenital:

42. Case six:
old male patient presented with pain less hematura and weight loss.

43. Tumor:

44. Case seven:
Young male patient involved in road traffic accident with blunt trauma to the abdomen.

45. Trauma:

46. THANK YOU