Radiology Notes

My notes during radiology residency, fellowship, and beyond…

Archive for the ‘renal’ Category

Wilm’s Tumor

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  • Age: 80% <6yo; most common abdominal neoplasm 1-8 yo.
  • Appearance: solid mass in kidney (claw sign), pushing away vessels, not crossing mid-line
  • IVC and renal vein thrombosis
  • Mets to lung, liver, brain, bone
  • Staging
    • I = confined to kidney
    • II = local extension to perinephric space
    • III = lymph nodes
    • IV = distant mets
    • V = bilateral renal
  • DDx: neuroblastoma (crosses mid-line, encases vessels, calcify), multilocular cystic nephroma, sarcoma, RCC, nephroblastomatosis, mesoblastic nephroma, AML, renal medullary carcinoma

 

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Written by lmwong

October 28, 2011 at 1:17 pm

Posted in abdomen, GU, pediatrics, renal

Renal Scintigraphy

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MAG-3 or DTPA

  • Perfusion/Obstruction
  • normal uptake 50/50 L and R kidney; >60/40 is abnormal
  • normal peak < 5 minutes
  • normal residual coritcal activiy < 0.3
  • Lasix
    • increases urine output
    • inject 15 min before MAG3/DTPA
    • no washout after Lasix = obstruction
    • normal T1/2 = < 10 min
    • obstructed T1/2 = >20 min
  • Captopril
    • evaluate renal artery (renal artery stenosis, ischemia, renovascular hypertension)
    • baseline scan, captopril scan, post scan
    • high prob RVH = marked captopril induced changed

DMSA = Morphology

  • for UTI or pyelonephritis, congenital malformation
  • cold spots: pyelonnephritis, tumors, cyts, hydronephrosis, trauma, infarct

Radionuclide Cystogram

  • UTI, VUR
  • sulfur colloid, DTPA, MAG-3
  • fill bladder until reverse flow

Source: ppt

Written by lmwong

March 31, 2010 at 10:39 am

Posted in nuclear medicine, renal

Pediatric Renal Tumors

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  • Wilm’s tumor
  • nephroblastomatosis
  • Clear cell sarcoma
  • Rhabdoid tumor
  • Hamartoma
  • Angiomyolipoma
  • Ossifying Renal Tumor of Infancy
  • Metanrphric Adenoma
  • Adjacent Neuroblastoma from adrenal gland

Written by lmwong

March 20, 2010 at 10:57 am

Pediatric Cystic Renal Lesions

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Written by lmwong

March 19, 2010 at 2:26 pm

Decreased renal echogenicity

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  • Acute pyelonephritis
  • Renal vein thrombosis
  • Acute glomerulonephritis
  • Lupus nephritis
  • Lymphoma

Written by lmwong

January 22, 2010 at 1:46 am

Increased renal echogenicity

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Cortical only:

  • Acute/Chronic Glomerulonephritis
  • Nephrosclerosis
  • Acute tubular necrosis

Medullary only:

  • Medullary nephrocalcinosis
  • Renal pyramidal fibrosis

Cortical and Medullary:

  • Chronic Plyeonephritis
  • Chronic Glomerulonephritis

Patchy:

  • Infection
  • Scarring
  • Renal Vein thrombosis

Written by lmwong

January 22, 2010 at 1:44 am

Big Kidneys Differential

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Unilateral

  • Compensatory hypertrophy
  • Pyelonephritis
  • Duplex kidney
  • Renal Vein Thrombosis
  • Hydronephrosis
  • Acute renal infarct

Bilateral

  • Unilateral cases as above
  • AD PCKD
  • AR PCKD
  • Glomerulonephritis
  • Acute tubular necrosis
  • Diabetic nephropathy

In Kids:

  • Nephroblastomatosis
  • Nephrotic Syndrome
  • Polycystic Kidney disease
  • Glycogen Storage
  • Lymphoma/Leukemia

Written by lmwong

January 16, 2010 at 10:45 am

Posted in differential, GU, renal