Ebook Abdominal imaging: Part 2
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Ebook Abdominal imaging: Part 2
Genitourinary systemThe genitourinary system consists of the renal tract and in males includes the reproductive organs such as the prostate, seminal v Ebook Abdominal imaging: Part 2vesiclesand testes. The kidneys are responsible for filtering the blood and extracting waste products that are excreted into the urinary bladder via the ureters. Disorders of the kidneys such as cancer may produce haematuria (blood in the urine), whereas poor renal function leads to elevation of ser Ebook Abdominal imaging: Part 2um creatinine and urea levels. Some common diseases affecting the renal tract are urolithiasis (renal stones) and chronic renal failure. In younger paEbook Abdominal imaging: Part 2
tients testicular torsion may present as an emergency. US is commonly the initial imaging modality used in the evaluation of the renal tract. It is alGenitourinary systemThe genitourinary system consists of the renal tract and in males includes the reproductive organs such as the prostate, seminal v Ebook Abdominal imaging: Part 2rtery stenosisRenal artery stenosis (RAS) is the most common cause of secondary hypertension. It is defined as narrowing of the lumen of the renal artery and is most commonly (two thirds) caused by atherosclerotic disease. Fibromuscular dysplasia is the second most common cause of RAS. Patients usua Ebook Abdominal imaging: Part 2lly present with very high blood pressure or acute onset of hypertension. A vascular bruit (turbulent flow noise) may be felt or heard in the flanks/aEbook Abdominal imaging: Part 2
bdomen.Key facts•Atheromatous plaques and calcification typically occur at the origin or within 2 cm of the origin of the renal artery from the aorta•Genitourinary systemThe genitourinary system consists of the renal tract and in males includes the reproductive organs such as the prostate, seminal v Ebook Abdominal imaging: Part 2unger patients (more often female), causing medial hyperplasia (middle layer) of the arterial wall•The area of narrowing is usually in the mid or distal renal arteries and is bilateral in two thirds of cases.Radiological findingsCT or MR angiography Along with traditional catheter angiography, CTA o Ebook Abdominal imaging: Part 2r MRA may be used to delineate the renal vasculature and detect areas of narrowing. Doppler studies can be carried out to assess blood flow velocitiesEbook Abdominal imaging: Part 2
through the renal arteries (see Figure 1.19).Angiography (CT, MR or catheter) Atheromatous stenosis is usually seen as eccentric areas of narrowing aGenitourinary systemThe genitourinary system consists of the renal tract and in males includes the reproductive organs such as the prostate, seminal v Ebook Abdominal imaging: Part 2arteries forming a 'string of beads' appearance (Figure 5.2).US with doppler There is an increase in the systolic peak velocity of blood flow through the renal arteries. A peak velocity >200 cm/s signifies severe (50-99%) occlusion whereas velocities between 100 and 200 cm/s are consistent with mode Ebook Abdominal imaging: Part 2st stenosis (<50%).Renal cell CdICII IUII Id I I DFigure 5.2 Angiographic image showing multiple stenoses (arrows) in the left renal artery forming thEbook Abdominal imaging: Part 2
e string of beads appearance.Key imaging findingsA.Narrrowing of renal arteryB.Multiple narrowing in fibromuscular dysplasiac. String of beads appearaGenitourinary systemThe genitourinary system consists of the renal tract and in males includes the reproductive organs such as the prostate, seminal v Ebook Abdominal imaging: Part 2l angioplasty). Surgical revascularisation has the best success rate in treating renal artery stenosis.5.2Renal cell carcinomaRenal cell carcinoma (RCC) arises from the tubular epithelium of the kidney and is also known as hypernephroma. It is the most common primary renal tumour (85%) and quite oft Ebook Abdominal imaging: Part 2en detected incidentally on CT or US. Symptoms typically include haematuria, flank pain or palpable masses.Key facts116 Genitourinary system• DistantEbook Abdominal imaging: Part 2
metastases may be the first presenting sign of RCC and the classic triad of haematuria, flank pain and mass is present in < 10% of patients.RadiologicGenitourinary systemThe genitourinary system consists of the renal tract and in males includes the reproductive organs such as the prostate, seminal v Ebook Abdominal imaging: Part 2hoic because they may contain cystic areas, septations and solid elements (Figure 5.4). High blood flow velocities are seen on Doppler studies due to AV (arteriovenous) shunting within the tumour. Abnormal AV connections and shunts are formed due to neovascularity and angiogenesis in renal tumours.C Ebook Abdominal imaging: Part 2T The typical appearance of RCC is that of a hyperenhancing mass located in the renal cortex (Figure 5.5). Calcification may be present in up to a thiEbook Abdominal imaging: Part 2
rd of cases. These tumours are best seen on early arterial phase imaging. Metastases are seen inFigure 5.3 Radiograph showing a faintly calcified rounGenitourinary systemThe genitourinary system consists of the renal tract and in males includes the reproductive organs such as the prostate, seminal vGenitourinary systemThe genitourinary system consists of the renal tract and in males includes the reproductive organs such as the prostate, seminal vGọi ngay
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