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92 Cards in this Set
- Front
- Back
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Mural bladder wall calcification?
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Bladder stone.. TCC.. Cystitis.. Foreign body encrustation.. Amyloidosis.
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Extrinsic displacement of bladder?
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Pelvic hematoma and urinoma. Pelvic mass. Bladder diverticulum. Lymphadenopathy. Pelvic lipomatosis. Iliopsoas hypertrophy.
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Intraperitoneal bladder rupture, CT characteristics?
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Lateral pelivic recess (lateral paravesical recesses superior to bladder). Midline pouch of Douglas (posterior to bladder and anterior to rectosigmoid)
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Extraperitoneal bladder rupture, CT characteristics?
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Perivesical space (extends anterior and superior to bladder to level of umbilicus). Retrorectal or presacral space.
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Ileal loop complications?
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Early (obstruction or extravasation at ureteroileal anastomosis). Late (chronic pyelonephritis, nephrolithiasis, obstruction).
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Filling defects in urethra?
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Calculus. Polyp. Carcinoma. Condylomata acuminata. Polypoid urethritis. Malacoplakia. Urethritis cystica. Metastases. Amyloidosis.
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Paraurethral outpouchings or tracts?
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(Pseudo)diverticulum. Fistula. Cowper's duct or gland. Glands of Littre. Mullerian remnants (utricle or Mullerian cyst).
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Ovarian neoplasms, types and frequency?
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Epithelial 65%. Germ cell 25%. Sex cord-stroma 5%. Secondary or metastatic 5%. Gonadoblastoma rare.
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Epithelial ovarian tumors?
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Serous. Mucinous. Endometrioid. Clear-cell. Brenn (rare).
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Serous or Papillary epithelial ovarian tumors?
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75% benign (large unilocular cyst). Malignant (solid masses, nodular walls, contrast enhancement).
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Mucinous epithelial ovarian tumors?
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95% benign (large multilocular cystic mass). Pseudomyxoma peritonei.
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Ovarian dermoid cyst (mature cystic teratoma)
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Primordial germ cell. Common in girls less than 15 yo. 15% bilateral. Torsion, trauma, infection, rupture. Sebaceous plug or tooth.
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Metastases to ovary
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Krukenberg tumors: Signet ring cells, mucinous ADCA from stomach or colon. Breast cancer. Lymphoma
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Nonseminomatous germ cell tumors?
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Embryonal cancer. Yolk sac cancer. Choriocarcinoma. Teratoma.
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Bilateral, Entire ureteral dilatation without ureteral obstruction?
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Bladder outlet obstruction. Prune-belly. Diabetes insipidus. Polydypsia. Primary megaureter.
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Unilateral, entire ureteral dilatation without ureteral obstruction?
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Vesicoureteral reflex (grades II-IV). Ectopic ureter inserting below bladder. Bacterial infection.
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Ureteral dilatation of distal segment only without ureteral obstruction?
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Primary megaureter. Vesicoureteral reflux (grade I).
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Ureteral dilatation of proximal segment only without ureteral obstruction?
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Retrocaval or retroiliac ureter. Enlarged urterus. Postpartum ectasia.
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Malignant causes of ureteral narrowing?
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Urothelial neoplasm. Local extension of extrinsic tumor. Distant metastasis. Lymphoma.
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Infectious causes of ureteral narrowing?
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TB. Schistosomiasis.
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Inflammatory bowel disease causes of ureteral narrowing?
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Regional enteritis. Diverticulitis. Appendicitis.
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Gynecologic causes of ureteral narrowing?
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Endometriosis.
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Traumatic causes of ureteral narrowing?
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Stone passage. Iatrogenic. Mechanical stone extraction. Ureterolithotomy. Radiation therapy.
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TCC features?
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2/3 papillary. 85% of urothelial neoplasms. 20% multifocal. Associations: aniline dyes, tobacco, analgesics, Balkan nephropathy.
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Uncommon associations with retroperitoneal fibrosis?
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Aortic aneurysm. Aortic graft. Retroperitoneal hemorrhage. Urinoma. Abscess. Metastases. Drugs. Bowel Disease.
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CT signs of ureteral stone?
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Homogeneous density in ureter lumen. Unilateral hydronephrosis. Hydroureter. Perirenal stranding. Nephromegaly. Loss of white renal pyramids. Kidney stones.
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Intraluminal ureteral filling defects
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Calculi. Blood clots. Sloughed papilla. Fungus ball. Mucopus. Air bubbles.
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Mucosal ureteral filling defects?
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Neoplasm. Edema. Leukoplakia.
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Mural ureteral filling defect?
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Ureteritis cystica. Hemorrhage. Malacoplakia. Endometreiosis. Schistosomiasis.
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Common causes of focal filling defects of the bladder wall?
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Neoplasm. Stone. Blood clot. Enlarged prostate.
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Malignant bladder neoplasms?
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TCC. SCC. Adenocarcinoma.
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Benign bladder neoplasms?
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Leiomyoma. Fibroepithelial polyp. Hemangioma. Pheochromocytoma. Adenoma.
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Outpouchings of bladder wall?
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Diverticulum and saccule (<5 mm). Cystocele. Herniation of bladder. Urachal diverticulum.
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Bladder diverticula features?
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Result from bladder neck or urethral obstruction. Congenital (Hutch diverticulum). Can cause ureteral obstruction or reflux. Urinary stasis may lead to stones or cystitis. 2% have carcinomas.
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Features of xanthogranulomatous pyelonephritis?
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Female predominance. History of UTIs. Nephrolithiasis. Renal enlargement. Renal hypofunction. Fractured calculus. Renal cysts. Extrarenal extension common.
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Features of renal infarcts?
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Wedge-shaped. Cortical rim sign. Usually multifocal. Progressive atrophy over time.
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CT findings of pyelonephritis?
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Renal enlargement. Multifocal wedge-shaped hetergeneous areas. Parenchymal striations.
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Differential of small scarred kidneys?
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Unilateral: Reflux nephropathy. Previous renal surgery. Bilateral: Normal calyces (renal infarcts). Abnormal calyces (bilateral reflux nephropathy or analgesic nephropathy).
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In reflux nephropathy scarring first develops?
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At renal poles.
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Differential of unilateral small smooth kidney?
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Normal calyces: Renal artery stenosis. Chronic renal vein thrombosis. Renal hypoplasia. Subcapsular hematoma. Radiation therapy. Abnormal calyces: Postobstructive atrophy.
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Urographic signs of renal artery stenosis
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Small smooth kidney. Delayed nephrogram. Delayed pyelogram. Hyperdense pyelogram. Ureteral notching.
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Causes of unilateral reniform enlargement?
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Ureteral obstruction. Duplication anomalies and hypertophy. Parenchymal infiltration (pyelonephritis, XGP, contusion, infiltrating neoplasm). Edema (acute renal vein occlusion, acute arterial occlusion/arteritis).
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Causes of striated nephrogram?
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Common: Acute ureteral obstruction. Pyelonephritis. Uncommon: ARPKD. Acute renal vein thrombosis. Renal contusion. Rare: Radiation nephritis.
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Common and uncommon causes of bilateral renal enlargement with masses?
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Common: ADPCKD. Uncommon: Acquired renal cystic disease. Simple cysts. Lymphoma. Metastases. Wilm's tumor.
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Causes of medullary nephrocalcinosis?
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Common: Medullary sponge kidney. Hypercalcemia. RTA. Uncommon: Papillary necrosis. TB. Hyperoxaluria. Chronic furosemide use.
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Causes of cortical nephrocalcinosis?
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Common: Chronic glumerulonephritis. Acute cortical necrosis. Uncommon: Hyperoxaluria. Rare: Alport's syndrome. Chronic transplant rejection.
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General causes of renal failure?
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Prerenal: Underperfusion. Renal: Diffuse parenchymal disease. Postrenal: Bladder outlet obstruction, Bilateral ureteral obstruction.
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Enlarged hyperechoic kidneys?
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HIV nephropathy.
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2 types of renal sinus fat proliferation?
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Renal sinus lipomatosis: increased fat with little mass effect. Replacement lipomatosis: renal atrophy, massive fat.
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Renal sinus cysts?
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Peripelvic: multiple, small, insinuating. Parapelvic: typical simple renal cyst. Uriniferous: urine extravasation.
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Renal sinus neoplasms
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Renal: RCC, AML, MLCN. Sinus: AML, teratoma, Lipoma/sarcoma, fibroma/sarcoma, neuroma/sarcoma, leiomyoma/sarcoma, malignant histiocytoma.
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Normal ureter course measurements and landmarks?
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less than 1 cm lateral to transverse process.. Not medial to vertebral pedicle. Ureters separated by > 5 cm.
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Right adrenal gland is located posterior to the
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Inferior vena cava (IVC) at the level where the IVC enters the liver.
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Radiographic abnormalities of Horseshoe kidney?
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Renal nonrotation. Lower pole fusion. Low retroperitoneal position. Renal vascular anomalies
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Other urinary tract abnormalities associated with horseshoe kidney?
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UPJ obstruction. Duplication anomalies. Stone formation. Pyeloureteritis cystica. Infection-based stone formation.
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Crossed fused ectopia?
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One kidney crosses midline and fuses with the other. Ureters insert in the bladder in their normal position (crossed kidney's ureter crosses midline).
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Radiographic findings of pelvoinfundibular MDK (Multicystic dysplastic kidney)?
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Randomly distributed cysts. Noncommunicating cysts. Absent renal function. Atretic ureter.
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Radiographic findings of hydronephrotic MDK (multicystic dysplastic kidney)?
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Dominant cyst in region of renal pelvis. Radially arrayed cysts may communicate. Minimal renal function possible. Ureter occluded at UPJ (ureteropelvic junction).
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Abnormalities with ARPKD (autosomal recessive polycystic kidney disease)?
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Oligohydramnios. Nephromegaly. Hyperechoic kidneys. Renal failure inversely proportional to hepatic failure.
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MSK (Medullary sponge kidney associations?
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Renal tubular ectasia. Nephrolithiasis. Medullary nephrocalcinosis. Caroli's disease. Ehler's-Danlos syndrome.
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Multilocular cystic nephroma associations?
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Benign cystic neoplasm. Young boys (1st decade). Adult women (3rd and 4th decades). Herniation of parenchymal mass into renal pelvis
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Bosniak CT classification of cystic renal masses?
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Class I: simple cysts, nonoperative. Class II: septated, minimal calcium, nonenhancing high-density cyst, infected cyst, nonoperative. Class III: multiloculated, hemorrhagic, dense calcium, non-enhancing solid component, renal-sparing surgery. Class IV: marginal irregularity, enhancing solid component, radical nephrectomy.
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RCC: IVU features?
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Expansile mass. calyceal displacement, compression. Ureteral notching. Diminished function, if renal vein occluded.
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RCC: CT, MR features?
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Approximately spherical shape. Fails criteria for simple cyst. Lacks internal fat (AML). Enhances.
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Other abnormalities that present with renal agenesis?
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Absent ipsilateral ureter. Absent ipsilateral hemitrigone. Absent ipsilateral vas deferens. Ipsilateral seminal vesicle cyst. Unicornuate uterus. Abnormal bowel gas pattern.
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Nonrotated verus malrotated kidney?
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Nonrotated: anterior positioned UPJ (Ureteropelvic junction). Malrotated (over-rotated): posterior positioned UPJ.
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Calyceal diverticulum, details?
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Intraparenchymal cavity lined with transitional epithelium that communicates with collecting system. Type 1 communicates with minor calyx. Type 2 communicates with infundibulum. Type 3 communicates with renal pelvis.
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Mesoblastic nephroma, details?
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Benign neoplasm. Hamartoma of the kidney. Diagnosed in children under 2. Mimic malignant neoplasms (Wilm's).
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Nephroblastomatosis associations?
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Increased risk of Wilm's tumor (multiple and bilateral). Young patients with renal enlargement and multiple subcapsular masses.. Primitive renal tissue that persists beyond 36 wks gestation.
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Organs within anterior pararenal space of retroperitoneum?
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Pancreas. Retroperitoneal colon (right and left). Duodenum.
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Organs within posterior pararenal space of retroperitoneum?
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None.
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Organs within perirenal space of retroperitoneum?
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Kidney. Adrenal gland. Collecting system. Renal and perirenal vasculature. Renal and perirenal lymphatics.
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Solitary expansile renal masses?
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Common: Cyst, RCC. Uncommon: AML, abscess, mets. Rare: Oncocytoma, MLCN, Localized renal cystic dz, Focal xanthogranumomatous pyelonephritis.
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Other areas of interest in abdominal imaging in RCC?
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Contralateral kidney. Renal vein. Vena cava. Regional lymph nodes. Ipsilateral adrenal gland. Adjacent organs. Liver. Skeleton.
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Features of oncocytoma?
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Males 6th or 7th decade. Solid expansile mass. Iso-heteroechoic at US. Homogeneous enhancement CT. Pseudocapsule. Central scar in larger lesions. Spoke wheel angiographic pattern.
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Features of multilocular cystic nephroma?
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50% males less than 3 yo. 50% females > 40 yo. Expansile, multiloculated cystic renal mass. Herniation into collecting system. Enhancing septa at CT. Absent hemorrhage. Hypo-or avascular at angiography.
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Features of renal abscess?
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Evidence of infection. Hypoechoic with less through transmission than cyst. Thick wall, rim enhancement CT. Perinephrich inflammatory changes. Neovascularity in wall on angiogram.
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Features of xanthogranulomatous pyelonephritis?
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Middle-aged females with UTIs. Focal hypofunctioning renal mass. Infection-based stones.
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Features of renal lymphoma?
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Usually with systemic lymphoma. Usually bilateral. Multifocal, diffuse, or focal. Hypoechoic without through-transmission. Often with massive lymphadenopathy.
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Features of angiomyolipoma?
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80% in adults (females). 4th-5th decade. 20% in tuberous sclerosis. Well-defined hyperechoic mass. Fat, even small amounts, diagnostic with CT. Neovascularity with aneurysm on angiography. Unlikely to bleed if less than 4 cm.
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von Hippel-Lindau disease?
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40% RCC. 75% simple renal cysts. Hemangioblastomas CNS. Retinal angiomas. Pancreatic cysts. Pancreatic neoplasms. 50-80% Pheochromocytomas (multiple, bilateral, extraadrenal).
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Tuberous sclerosis features?
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Renal cystic disease. 80% AMLs. Cerebral hamartomas. Cardiac rhabdomyomas(sarcomas). Skeletel osteomas. Pulmonary lymphangioleiomyomatosis.
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Infiltrative renal neoplasms?
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TCC. SCC. Infiltrative RCC. Renal medullary carcinoma. Renal lymphoma.
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Distinctions of GU SCC versus TCC?
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SCC more aggressive. Fast-growing. 50% SCC have coexistent renal calculus.
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Renal medullary carcinoma
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Patients less than 40 yo. Sickle cell trait > disease. Poor prognosis, < 4 months.
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Weigert-Meyer rule?
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Duplication anomaly. Upper moiety ureter inserts inferior and medial to normal (lower moiety) bladder insertion.
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Medial deviation of upper ureter?
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Lower-pole renal mass. Lateral retroperitoneal mass. Psoas hypertrophy. Retroperitoneal fibrosis. Retrocaval ureter.
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Medial deviation of lower ureter?
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Lymphadenopathy. Pelvic lipomatosis. Iliopsoas hypertrophy. Pelvis mass/fluid collection. Iliac vessel ectasia. Abdominopelvic resection. Cystocele.
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Lateral deviation of upper ureter?
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Malrotated or horseshoe kidney. Lymphadenopathy. Psoas hypertrophy. AAA. Retroperitoneal mass/fluid. Ureter mobilization surgery.
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Lower ureter lateral deviation?
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Central pelvic mass/fluid collection. Sciatic ureteral hernia.
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Retrocaval ureter: urography findings?
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Right ureter. Abrupt medial deviation. Course medial to pedicle. Fish-hook shape. Hydronephrosis.
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Pelvic lipomatosis features?
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Young African male. Bilateral hydronephrosis. EXtrinsic bladder compression. tear-drop bladder .
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