Radioanatomy of Kidney,

Ureter and Urinary

bladder

Presented by
Capt Alauddin
MD residency phase A
•Radio anatomy means study of
anatomy through the use of
radiographic films.

•The density differences in

radiograph have to be described in
terms of anatomical structure.
Objective
To identify the
Kidneys, ureters and
urinary bladder in
different imaging
modalities
Kidneys
 Retroperitonial organs that
maintain electrolyte
homeostatsis and function for
waste excretion.

 location – T-12 to L-3

vertebra
In upright position the
kidneys descend by 2 to 3 cm
Rt kidney is slightly lower
than the left kidney
Long axis is directed
downward and laterally
Kidneys have
2 poles: upper and lower
2 borders : medial and
lateral
2 surfaces : ant and post
Capsules of kidney:
Fibrous capsule : Covers
the kidney
Perirenal fat: Layer of
fat surrounding the
fibrous capsule

Renal fascia of Gerota:

Fibroareolar tissue
surrounding the kidney
and perirenal fat.
Pararenal fat: Fat that
surrounds renal fascia
Internal structures
Cortex: 2 parts cortical arch and renal collumn

Medulla : 27-30 conical masses called renal

pyramids the apices of which indent the minor
calyces and bases are covered by cortical arches
Ureters
Connects the renal pelvis to the
bladder and is 25–30 cm long.
• Diameter :3 mm
•has three ‘functionally’
narrow regions:
· junction of renal pelvis with
ureter
• as the ureter crosses bony
pelvic brim
· intravesical ureter where it
runs obliquely through the
muscular bladder wall
Urinary bladder
The urine
produced by
kidney is
temporarily
stored in urinary
bladder till it is
cleared to the
exterior through
the urethra.
Imaging modalities of KUB
•Plain X ray
•IVU
•USG
•CT scan
•MRI
•Renal angiography
•Cystography
•Voiding cystourethrography
In plain X ray:
Only renal outline is seen. The renal edge may be
visible, outlined by the surrounding perirenal fat.

Ureter is not visible in normal case.

The bladder may be outlined by the perivesical fat.
IVU shows
Kidney ,ureter
urinary bladder.
Renal parenchyma
is seen in
nephrographic
phase

Collecting system in
pyelographic phase
USG:
Kidneys are Hypoechoic compared to liver parenchyma .
USG allows multiplanar evaluation of renal anatomy:
assessment of size, parenchyma, the pelvicalyceal system,
masses and calculi can be readily performed.
Collecting system anechoic if distended. Echogenic when
collapsed .
Ureter : Not seen, unless dilated
CT
Kidneys are isodense to liver before contrast. Hyperdense
to liver post contrast
collecting system visualized > 120 s
Ureter : Isodense before contrast,
Visualized > 120 s after contrast
MRI
Dependent on state of hydration Cortex of higher
signal intensity (SI) on T1W image
(corticomeduallary junction may be seen)

Ureter : Hyperintense on T2W image

Renal vasculature: Renal arteries branch from the
bdominal aorta laterally between L1 and L2
the rt renal artery pass posterior to the IVC

Renal vein drain into the inferior venacava. Renal veins

lie anterior to arteries.
Common anomalies of the kidney and ureter

Anomaly
Renal agenesis
Pelvic kidney
Horseshoe kidney
Pancake’ (discoid) kidney
Crossed renal ectopia