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Imaging of the upper urinary tract (Part 1).
Dr/ ABD ALLAH NAZEER. MD.
Renal infection.
streaky contrast staining in the area of inflammation, typical of pyelonephritis with striated nephrogram (black arrow).
Acute pyelonephritis of the right and left kidney with striated nephrogram.
Pyohydronephrosis.
Pyohydronephrosis.
Emphysematous pyelonephritis.
Emphysematous pyelonephritis.
Xanthogranulomatous pyelonephritis in a 80-year-old woman with chronic pyuria.
CT is the most sensitive modality for visualizing renal calcifications and CT IVP is more sensitive at identifying all manifestations of renal tuberculosis . Early papillary necrosis (single or multiple) resulting in uneven caliectasis progressive multifocal strictures can affect any part of the collecting system generalized or focal hydronephrosis mural thickening and enhancement poorly enhancing renal parenchyma, either due to direct involvement or due to hydronephrosis end stage progressive hydronephrosis results in very thin parenchyma, mimicking multiple thin walled cysts amorphous dystrophic calcification eventually involves the entire kidney (known as putty kidney).
Tuberculous autonephrectomy.
Renal cystic and solid masses.
Kidney - Cystic masses. Renal cysts can be classified according to the Bosniak classification depending on their features. Type I cysts are simple cysts.Type II are the minimally complicated cysts. Type I and II can be ignored. Type II F are probably benign, but need to be followed. Type III and IV both are surgical lesions. Type IV is inevitably malignant and in the type III group about 80-90% turn out to be malignant as well.
Axial and coronal reformatted CT images of simple renal cyst (Bosniak category 1 cyst.
LEFT: thin, smooth septation.....Ignore RIGHT: thick enhancing septation ... Excise
Bosniak Type 111.
Bosniak Type 1V.
Multilocular cystic nephroma.
Oncocytoma of right kidney. Triphasic study.
Renal oncocytoma.
Renal angiomyolipoma.
Renal cell carcinoma with CT angiography.
Renal mass with invasion of the renal vein and IVC.
Renal cell carcinoma.
Transitional cell carcinoma of the renal pelvis.
Transitional cell carcinoma of the renal pelvis is uncommon compared to renal cell carcinoma, and can be challenging to identify on routine imaging when small.
Transitional cell carcinomas account for 85 % of all uroepithelial tumors of the renal pelvis (the remaining 5 % being made up of squamous cell carcinoma (the majority) and adenocarcinoma (rare)1. They have one of two main morphologic patterns:papillary
account for >85% tumors 1
multiple frondlike papillary projectionstend to be low grade and invasion beyond the mucosa is a late feature
non-papillary sessile or nodular tumorstend to be high grade with early invasion beyond mucosa.
Cases of renal transitional cell carcinoma.
Renal transitional cell carcinoma.
Renal transitional cell carcinoma.
Transitional cell carcinoma.
Bilateral renal lymphoma with splenic involvement.
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Renal metastasis
Thank You.