Urologic radiology最新文献

Renal extracorporeal shock wave lithotripsy (ESWL) is a noninvasive and effective method for the treatment of a variety of urinary tract calculi with significantly lower morbidity than both surgical procedures for stone removal (pyelolithotomy/ureterolithotomy) and percutaneous nephrostolithotomy. Though significant, severe complications are rare, ESWL therapy can result in a wide spectrum of tissue injury. This article serves to review the currently known complications of ESWL, which radiologists may encounter, providing an understanding of the potential effects of shock waves on body organs and the resultant functional and morphologic changes that may result.

Contrast-urine levels are routinely seen in contrast-enhanced computed tomography (CT) of the pelvis with contrast-opacified urine in the bottom and unopacified urine in the top. We encountered four cases in which contrast-urine levels were reversed. The reversal of the contrast-urine level was probably caused by high specific gravity of the preexisting urine in the bladder due to infectious debris or mucous threads in the urine.

The growth of renal angiomyolipomas in adult tuberous sclerosis patients has not been previously reported. We report one such case of the growth of an angiomyolipoma in a previously documented angiographically normal appearing kidney after the contralateral kidney was removed for angiomyolipoma 15 years earlier.

Acute renal cortical necrosis is a rare cause of acute renal failure that is usually associated with third trimester obstetrical complications. The appearance of this condition on contrast-enhanced computed tomography (CT) has rarely been described. A case of acute cortical renal necrosis is presented and the findings on contrast-enhanced CT are described. The pathologic correlation is also presented.

Renal peripelvic lymphatic cysts (lymphangiomas) are usually seen as an isolated finding. They appear as multiple mass lesions with low attenuation on computed tomography (CT), and show no contrast enhancement. We present a case of renal peripelvic lymphatic cysts associated with generalized lymphangiomatosis, and examined with magnetic resonance imaging (MRI), CT, and lymphangiography. Multiplanar MRI demonstrated the extent of disease, including retroperitoneal lesions. The lesions had low-signal intensity on T1-weighted and high-signal intensity on T2-weighted images. The diagnosis of generalized lymphangiomatosis was verified by renal sinus cyst puncture, lymphangiography, and tissue biopsy.

A case of a 42-year-old man with non-Hodgkin lymphoma of the ureter is reported. Diffuse lymphomatous infiltration of the ureter occurs rarely and is an uncommon cause of ureteral obstruction. Imaging-pathologic correlation is presented with CT images and autopsy specimens.

Laparoscopic laser surgery is becoming increasingly common as treatment for endometriosis. We report a case of computed tomographic (CT) demonstration of salpingoureteral fistula secondary to laparoscopic laser surgery.

Patients with end-stage kidney disease, particularly those treated with dialysis, have an increased risk of renal cell carcinoma. Renal cell carcinoma may also develop in the native kidneys of renal transplant recipients with good graft function many years after transplantation. Recent studies suggest that the incidence of renal carcinoma among dialysis patients is 3-6 times greater than in the general population. However, annual imaging of the native kidneys of all dialysis patients is not justified because it has not been shown to have a significant effect on patient outcome. Screening may, however, be useful in selected patients with good general medical conditions and who have known risk factors for renal carcinoma.

One hundred twenty-six new renal transplants were scanned regularly with color Doppler ultrasound (CDU). In 22 (17.5%) of the grafts there was evidence of postbiopsy arteriovenous (AV) fistula during the first 6 months postoperatively. In 14 cases the fistula closed spontaneously. In the remaining eight, the fistula was still present up to 24 months later (four cases) or until the graft failed (four cases). Additionally, 163 established grafts were scanned for evidence of vascular abnormality. AV fistulas were observed in 15 grafts (8%). Circulatory complications of fistulas observed include vascular steal and a possible association with graft vein and artery stenosis.