Radiology Notes

My notes during radiology residency, fellowship, and beyond…

Archive for the ‘ureteral’ Category

Vesicoureteral Reflux (VUR) Classification

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Grade I – reflux into non-dilated ureter
Grade II – reflux into the renal pelvis and calyces without dilatation
Grade III – mild/moderate dilatation of the ureter, renal pelvis and calyces with minimal blunting of the fornices
Grade IV – dilation of the renal pelvis and calyces with moderate ureteral tortuosity
Grade V – gross dilatation of the ureter, pelvis and calyces; ureteral tortuosity; papillary impressions


Written by lmwong

September 8, 2008 at 12:04 am

Grades of Ureteral Reflux

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Grade Findings
I Reflux confined to ureter only
II Reflux to the level of the intrarenal collecting system without dilatation
III Grade II + mild or moderate dilatation of the ureter or renal pelvis, but no or only slight forniceal blunting
IV Grade II + calyceal dilatation and obliteration of the sharp angle of the fornices, but maintainance of the papillary impressions
V Gross dilatation and tortuosity of the ureter; gross dilatation of the renal pelvis and calices; papillary impressions are no longer visible

Grades I-III: Typically resolve as the child grows

Grades IV-V: Typically require surgery to correct

Written by lmwong

May 27, 2008 at 8:29 pm

Ureteral Filling Defect

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  • urothelial neoplasm
  • metastasis
  • fibroepithelial polyp


  • ureteritis cystica
  • tuberculosis
  • endometreosis


  • calculus
  • slouphed papilla
  • blood clot

Written by lmwong

April 11, 2008 at 7:00 pm

Posted in differential, ureteral

Ureteral Dilitation

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  • Obstruction: Ureterolithiasis
  • Congenital: Chronic vesicoureteral reflux, posterior urethral valves, megaureter, Prune-belly syndrome.
  • Infection/Inflammation: UTI, appendicitis, diverticulitis
  • Compression: pelvic or abdominal mass

Megaureter: disproportionally enlarged compared to the rest of the renal collecting system

  • reflux
  • obstruction
  • other: congenital megaureter, polyuria, infection

Written by lmwong

April 11, 2008 at 5:39 pm

Lateral Ureteral Deviation

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Upper ureter:

  • Lymphadenopathy
  • Aortic aneurysm
  • Retroperitoneal hematoma

Lower ureter

  • Pelvic mass, e.g. uterine fibroids

Written by lmwong

April 11, 2008 at 5:10 pm

Medial Ureteral Deviation

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Upper ureter:

  • Retrocaval ureter
  • Retroperitoneal fibrosis

Lower ureter:

  • Lymphadenopathy
  • Iliac artery aneurysm
  • Bladder diverticulum
  • Post-surgical (esp. AP resection)
  • Pelvic lipomatosis

Written by lmwong

April 11, 2008 at 4:57 pm