Professional Documents
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How to approach
plain KUB / scout film
1.
2.
3.
4.
-
-
-
-
Kidneys (look at
position, size, shape,
renal outline)
Psoas muscle
T12
L1
L2
L3
Kidneys (look at
position, size, shape,
renal outline)
Psoas muscle
L4
L5
Dx. Emphysematous
pyelonephritis
4. Bony structures
IVP
Scout film
3 minutes
Renal nephrogram
-Look at kidneys position,
size, shape, cortical
thickness, renal outline
- Look for filling defect
Normal nephrogram
Scout
5 mins
10 mins
Point of
obstruction
Scout
Normal kidney
excretion
5 mins
No kidney excretion
10 mins
scout
5 mins
delay
Not enhanced
scout
5 mins
delay
IVP
10 minutes
30 minutes
Scout
5 mins
10 mins
Point of
obstruction
Scout
Normal kidney
excretion
5 mins
Delayed
enhancement
And contrast
more dense
10 mins
Hydronephrosis / Hydroureter
Filling defect
Filling defect in left distal ureter
Normal pelvocalyceal
system
IVP
Full bladder
- Look at bladder
- Size
- Shape
- Position
- Architecture
- Density
- Look for filling defect or
outpouching lesion
Filling defect
Filling defect
from BPH
IVP
Post voiding
- Evaluate residual urine
Congenital abnormalities
Renal agenesis
Supernumerary kidney
Malrotation
Pelvic ectopia
Right kidney
Right ureter
Left ureter
Horseshoe kidney
Ureterocele
Polycystic kidney
Plain KUB
For stone detection
Plain KUB
For stone detection
There is calcification
overlying the right renal
shadow, suggestive of
right renal stone
Ultrasound
Confirm obstruction
Hydronephrosis
IVP
Evaluate
1. Renal function
2. Anatomical change
3. Cause
Delayed dense
nephrogram
Normal excretion
Delayed excretory
function
5 minutes
IVP
Evaluate
1. Renal function
2. Anatomical change
3. Cause
Hydronephrosis
Hydroureter
Point of obstruction at
mid ureter
IVP
Evaluate
1. Renal function
2. Anatomical change
3. Cause
Mechanical obstruction
Stone
Ureteropelvic
junction (UPJ)
Medial isthmus
Uretervesical
junction (UVJ)
Tumor
Multiple filling defects in left
pelvis and ureter
Extrinsic compression
Blood clot
Stricture
Non-mechanical obstruction
Vesicoureteric reflux
1. Bladder trabeculation
2. Pine tree appearance
Renal mass
Simple cyst
Calyceal displacement
Smooth, well-defined
anechoic lesion
Distal acoustic
enhancement
Complicated cyst
Internal septation
High denisty fluid
Solid mass
Renal AML
Wilms tumor
Lymphoma
Metastasis
hydronephrosis
Cystic renal lesion
Simple cyst
Complicated
cyst
Follow up US
Do nothing CT scan
Biopsy
CT scan or MRI
-characterization
-location
-staging
-evaluate contralat.kidney
Acute pyelonephritis
Nephrographic defect
Striated nephrogram
Emphysematous pyelonephritis
Air
Free air outlining both kidneys
Air
Renal abscess
Abscess
Perinephric abscess
Pyonephrosis
Hyperechoic content in
renal pelvis
Tuberculosis
moth-eaten
calyx
Amputation of bilateral
upper pole calices
Infundibular stenosis
Tuberculosis
Renal trauma
Stable
patient
Unstable
patient
US
Hematoma
CT scan
Angiogram
No hematoma
IVP
Renal trauma
Ureteric trauma
hydronephrosis
hydroureter
Point of obstruction
Bladder trauma
Bladder contusion
Extraperitoneal rupture
Intraperitoneal rupture
Urethral trauma
Case 1
A 53-year-old female
was sent for IVP study
Scout film
5 minutes
10 minutes
30 minutes
Full bladder
Post void
Answer
CT scan
Horseshoe kidney
Case 2
Spot diagnosis
Answer
Case 3
A 3-months-old boy
was sent for IVP study
where is the
abnormality?
IVP 10 min
Describe the
abnormal finding
Full bladder
Answer
Ectopic ureterocele
Case 4
A 56-year-old male
was sent for ultrasound evaluation
liver
liver
US
liver
Rt kidney
Rt kidney
Lt kidney
US
liver cysts
Bilateral
renal cysts
Multiple cysts in
liver and kidney
CT scan
Case 5
Describe the
findings
1. Describe the
findings
2. Give the
diagnosis
Post void
Answer
Findings
stone
obstruction
at UPJ
hydronephrosis
Case 6
A 46-year-old male
Where is the
abnormality
1. Describe the
abnormality
2. Give the
diagnosis
IVP
10 min
Answer
Calcification in
renal pelvis
Case 7
Describe the
abnormality
Scout
Answer
Small size
right kidney
Enlarged
left kidney
Case 8
A 42-year-old male
Hx: left flank pain
Scout
1. Describe the
abnormality
2. Give the
diagnosis
Answer
- Delayed dense
nephrogram
- No contrast
excretion
Case 9
37-year-old female
Which kidney
is abnormal?
Described the
abnormalities ..
Answer
Case 10
A 73-year-old male
Hx: Microscopic hematuria
1. Where is the
abnormality?
2. What is the
diagnosis?
IVP 5 minutes
Describe the
findings..
IVP 5 minutes
Focal caliectasis
at upper pole
Answer
Case 11
A 66-year-old female
Where is the
abnormality?
Describe the
abnormality?
Round calcification
at LUQ
Case 12
Outline the
lesion..
IVP
Describe the
findings
Case 13
A 46-year-old female
Presented with palpable mass at
right-sided abdomen
Describe the
abnormality..
Can you outline both
renal and psoas
shadows?
Psoas shadows
hydronephrosis
Cystic renal lesion
Simple cyst
Complicated
cyst
Follow up US
Do nothing CT scan
Biopsy
CT scan or MRI
-characterization
-location
-staging
-evaluate contralat.kidney
Case 14
Hx. hematuria
Answer
Irregular filling
defect at left-sided
bladder
Foleys catheter
CA bladder
Case 15
Answer
Study: VCUG
Dx: Grade II VUR
Case 16
Hx. trauma
Answer
Intraperitoneal
extravasation
Outline of bowel loops
Bladder dome
Case 17
Hx. trauma
Answer
Extravasation into
perivesciular space
and
extraperitoneum
Extraperitoneal bladder
rupture
Case 18
Renal trauma
Stable
patient
Unstable
patient
US
Hematoma
CT scan
Angiogram
No hematoma
IVP
Diagnosis..
kidney
Perinephric hematoma