Urologic radiology最新文献

Scrotal pain is initially evaluated by color Doppler ultrasonography providing information on the presence or absence of flow within the testis and B Scan imaging providing important complementary information about lesions such as torsion of the appendix testis and testicular abscess. While radioisotope scanning provides similar information to color Doppler about testicular flow, it does not demonstrate the anatomy. Testicular imaging is extremely sensitive for "silent masses" and useful to evaluate palpable ones. Characteristic findings may be seen with simple testicular cysts and epidermoid cysts. Homogeneously hyperechoic masses have a variety of etiologies but are virtually always benign. A major limitation of a ultrasonography is the large number of nonneoplastic lesions which may mimic tumors.

The computed tomographic (CT) and magnetic resonance (MR) appearance of a retrovesical leiomyoma in a male patient is presented. Although leiomyomas are common lesions, the location within the retrovesical pouch is very unusual.

The pseudocapsule of renal cell carcinoma (RCC) appears as a low-intensity band or rim on magnetic resonance (MR) images. The frequency of its appearance differed on T1- and T2-weighted images. In our group of 19 RCC (in 18 patients), it appeared on 26.3% of T1-weighted images and on 57% of T2-weighted images. The pathology of the pseudocapsule on MR is its thickness and composition. On T1-weighted images, the appearance of the pseudocapsule is mainly related to the fibrous element, and on T2-weighted images to the fibrous element and compressed renal parenchyma.

Five renal cystic diseases have significant extrarenal manifestations: autosomal dominant polycystic kidney disease (ADPCK), autosomal recessive polycystic kidney disease (ARDCK), tuberous sclerosis (TS), von Hippel-Lindau Syndrome (VHL), and medullary cystic disease (MCD). Knowledge of these extrarenal manifestations is important since they may precede, present simultaneously, or follow the onset of the renal cystic disease. This article discusses the most significant extrarenal manifestations of these five renal cystic diseases: (1) ADPCK: hepatic cysts and cardiovascular abnormalities; (2) ARDCK: portal hypertension; (3) TS: hamartoma-like tumors of other organs; (4) VHL: central nervous system hemangioblastomas and paragangliomas; and (5) MCD: congenital hepatic fibrosis. Detecting extrarenal manifestations may be helpful (1) in confirming the renal cystic disease; (2) in thoroughly evaluating the patient with known renal cystic disease, and (3) if they antedate the renal cystic disease, their presence will alert the radiologist to evaluate the kidneys.

Magnetic resonance (MR) imaging, ultrasound, and computed tomography (CT) were performed for diagnosis and follow-up of rhabdomyosarcoma (RMS) arising from the genitourinary tract in five children, pelvic musculature in one, and the perineum in three others. MR imaging performed at 1.0 T included the following: spin-density-, T1-, and T2-weighted images in all nine patients; gadopentatate dimeglumine (Gd-DTPA)-enhanced T1-weighted images in five; and short TI inversion recovery (STIR) images in two children. Longitudinal T1-weighted images were of additional help in localizing the primary tumor at diagnosis and detecting local spread. Residual or recurrent disease within the bladder was best detected by spin-density images. Gd-DTPA enhancement improved contrast in two studies, but paramagnetic artifacts obscured intravesical lesions in three other studies. STIR images disclosed pelvic and retroperitoneal lymphadenopathy. MR imaging is recommended as the key method of diagnosis and follow-up of pelvic RMS.

Ultrasound is an integral tool in the contemporary assessment of urinary tract obstruction. Pulsed and color Doppler have eliminated many previous false-positives due to blood vessels or non-obstructive hydronephrosis. Limitations of the ultrasound technique still exist and on occasion necessitate the utilization of intravenous urography.

Computed tomographic (CT) evaluation of an abdominal mass diagnosed a huge 2-L congenital bladder diverticulum that caused urinary retention and ureteral compression leading to renal failure. The patient's renal failure resolved with decompression. His voiding dysfunction and retention resolved following diverticulectomy.

The unusual features of nine oncocytomas in five patients are reported herein. These include multiplicity in two, bilaterality in two, calcification in one, and association with renal cell carcinomas in three patients. Radiologists should be aware of these findings for this benign renal neoplasm.

During the last 20 years percutaneous nephrostomy has evolved as one of the basic procedures in the management of obstructive uropathy. This procedure is now widely available, it is relatively safe, and it offers rapid treatment of urinary obstruction regardless of underlying cause. Percutaneous nephrostomy is also the first step in a variety of antegrade ureteral procedures, including stent placement and ureteral dilation.