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28 Cards in this Set
- Front
- Back
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How does a right lateral radiograph affect the kidneys?
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Increases the distance b/w renal shadows
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True or false. Both kidneys should be present on a lateral radiograph.
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False, May not see the right kidney due to silhouette w/ adjacent liver, may not see left kidney due to feces and ingesta-Don't freak out!
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What is the normal size of a kidney in a dog and cat?
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Dog: 2.5-3.5 x length of L2
Cat: 2.4-3.0 x length of L2 MEASUREMENTS ARE ALWAYS ON VD!!!!! |
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What is involved in performing an excretory urograph?
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-Enema
-Patient must be well hydrated! (so can filter through contrast) -Always do survey films -Inject 400mg/lb IV as a blus -Acquire films immediately 5,10,20 and 40 minutes (both lateral and VD) |
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What contrast media is used for excretory urograms?
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Iodinated water-soluble contrast medium
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What is gained by performing an excretory urogram?
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-Improves morphologic assessment of kidney
-Poor test of function but will tell you a little bit about the filtration rate |
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What are 4 contraindications for excretory urogram?
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1) Azotemia & dehydration (if kidneys aren't working will retain media=trouble)
2) Pheochromocytoma 3) Multiple myeloma 4) Prior allergic reactions to contrast media |
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**What are the 4 phases of an excretory urogram?
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1) Arteriogram-immediately
2) Nephrogram-within 20 seconds of injection 3) Pyelogram-begins 3-5 minutes post injection 4) Cystogram-as contrast is cleared into the lower urinary tract |
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What are the phases of the excretory urogram from left to right?
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1. Arteriogram
2. Nephrogram 3. Pyelogram 4. Cystogram 5. Cystogram |
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What does the arteriogram phase of the excretory urogram show? How long is it?
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-Documents initial blood flow to the kidney
-Very short, seldom imaged |
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What does a normal nephrogram show?
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Contrast is filtered and accumulates w/in the renal tubules
-Should see good initial opacification that gradually fades over the study period -Opacification of kidneys should be uniform and symmetrical |
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What does the contrast outline in a pyelogram? What can be evaluated?
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The collecting system is oulined, will be able to evaluate the renal pelvic and diverticuli
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How big should a normal renal pelvis, recess, and proximal ureter be?
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Pelvis: <2mm wide
Recesses: < 1mm wide Proximal ureters: <2.5 mm in diameter |
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What does a cystogram show?
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-Contrast material entering the lower urinary tract
-See segmental images of the ureters and outline of bladder |
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Label the numbers
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1=diverticuli (recesses)
2=renal pelvis 3=cortex 4=medulla 5=ureter |
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What does it mean if you are performing an excretory urogram and you see contrast being eliminated in the feces?
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Means kidneys aren't working so contrast is being eliminated by alternative routes
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How do you know if contrast induced renal failure occurs when performing an excretory urogram?
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See opacification of kidneys that persists or becomes more intense over time
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What are 4 pathogeneses that possibly account for contrast induced renal failure?
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1) Hypotension
2) Acute tubular necrosis 3) Tubular obstruction 4) Acute renal failure |
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What are 2 alternative routes of excretion of contrast media used for excretory urograms?
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Liver & GI
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What does a poor nephrogram look like?
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Poor initial opacification followed by progressively decreasing opacity
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What are 2 differentials for a poor nephrogram?
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1) Primary polyuric renal failure
2) Inadequate contrast medium dose |
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How much contrast is normally eliminated in the feces?
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Normally no more than 2% (not much increase in density)
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What 6 kidney characteristics should always be evaluated on a radiograph?
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1) Number
2) Size 3) Shape 4) Margination 5) Location 6) Opacity |
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What are 4 differentials for a kidney condition where the kidneys are still a normal size & shape?
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1) Amyloidosis (have to biopsy for diagnosis)
2) Glomerulonephrosis 3) Acute pyelonephritis 4) Familial renal disease -May be normal -Small and smooth -Small and irregular |
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What are 5 differentials for bilateral renal enlargement?
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1) Lymphoma
2) FIP 3) Hydronephrosis 4) Polycystic kidney disease 5) Rare primary renal neoplasia |
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How can you tell that there's right renal enlargement in a radiograph?
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-Increased focal opacity in right craniodorsal region
-Medial & ventral displacement of the descending duodenum and ascending colon -Left ventral displacement of the small intestine |
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What is displaced with left renal enlargement?
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Ventral and medial displacement of the descending colon and adjacent small intestine
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What are 2 differentials for increased opacity of the kidneys?
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Calculi
Mineralization (nephrocalcinosis) |
