Urologic radiology最新文献

Several techniques for achieving palliative ureteral occlusion in cases of underlying malignant diseases are known to exist. We performed nine ureteral occlusions on seven patients, using two different techniques (occlusion by detachable balloon and by "Harzmann Olive"). Initially, complete occlusion of all ureters was attained; in two cases a second occluding intervention had to be carried out after a period of 6 and 14 weeks. Six of seven patients enjoyed a marked improvement of their quality of life after occlusion. Complications were down to a minimum. In comparison with other techniques described in the literature, Harzmann's method seems to be the simplest, as well as the most fully developed one. It may also be recommended for patients in an advanced tumor stage.

Owing to the noninvasive nature, ready availability, and efficacy, radionuclide studies remain widely utilized following renal transplantation for monitoring changes in the functional status and detection of detrimental complications of the grafted kidney. Whereas surgical complications, including vascular occlusion, urine extravasation, drainage obstruction, hematoma, or lymphocele formation, can often be detected effectively, specification of other underlying causes of deterioration of parenchymal function, including acute tubular necrosis (ATN), various types of rejection, and cyclosporine A nephrotoxicity (CyA-NT), frequently cannot be derived independently from the findings of a study without clinical correlation. Besides imaging, plotting of renogram or time/activity curves, numerous quantitative methods have been introduced to provide objective measurements of the blood flow, as well as to gauge the capability of concentration and excretion of the transplanted kidneys. However, the findings whether qualitative or quantitative all have overlapping zones. There is no abnormal image, graphic, or numeric index absolutely specific for any of the possible posttransplant renal parenchymal complications. The differentiation of such conditions may best be achieved through chronologic association of the sequential changes, with or without quantification, detected in serial studies with the clinical presentation and findings.

Abdominal, ultrasonography (US) performed on a middle-aged patient who presented with partial urinary retention, long lasting lower back pain, and abdominal pain revealed a cyst in the midline of the prostate. The cyst, which protruded into the bladder, was punctured under US guidance transvesically and sclerotized with 1% Aethoxysklerol. Following this procedure, the patient became steadily free of his complaints and is voiding without retention.

The authors describe computed tomographic (CT) and magnetic resonance (MR) imaging of coexistent anomalies of the inferior vena cava and renal venous system. These were particularly relevant due to the presence of a renal neoplasm which invaded an anomalous renal vein.

A case of a hyperdense renal cortical cyst resulting from cyst puncture and opacification 28 months previously is reported. Prolonged retention of water-soluble iodinated contrast material is an unusual cause of a hyperdense renal cyst, which has not previously been described. The findings on serial computed tomography (CT) and chemical analysis are presented and discussed.

Pseudoxanthoma elasticum (PXE) is a rare hereditary disease whose basic abnormality is degeneration of elastic tissue, with calcification of the tonaca media of the arteries, and typical yellowish papules of the skin. We report the sonographic findings observed in a young patient with PXE at the level of the kidneys: fine hyperechogenic spots suggesting small calcifications were diffuse at the corticomedullary junction; however, normal waveforms were obtained at the level of intraparenchymal renal vessels. The presence of this structural pattern in a young patient with dermatologic abnormalities should lead to the consideration of PXE in the differential diagnosis list.

Renal imaging has dramatically improved since the introduction of ultrasound (US), computed tomography (CT), and most recently magnetic resonance (MR) imaging. US and MR imaging are ideal for patients with compromised renal function preventing administration of iodinated contrast material or those who have experienced reactions to contrast. Staging errors occur due to limitations in assessing microscopic tumor invasion of the renal capsule and perinephric fat, detecting metastatic deposits in normal sized lymph nodes and differentiating inflammatory hyperplastic lymph nodes from neoplastic ones. These limitations are shared by US, CT, and MR imaging. Vascular invasion by tumor can be evaluated by all imaging modalities including venography. The advantages and limitations of each examination will be presented.

A case of metastatic transitional cell carcinoma (TCC) to the ovaries in a patient with prior grade I TCC of the bladder, which morphologically resembled a primary ovarian malignancy on computed tomography (CT), is described. Other tumors whose ovarian metastases can resemble primary ovarian tumors are also listed.

A patient was shown by computed tomography (CT) to have a rare developmental anomaly of the inferior vena cava (IVC), in which the iliac venous confluence is located anterior (rather than posterior) to the right common iliac artery. Recognition of the anomaly is important prior to surgical intervention in that area, as well as to prevent misinterpretation of the anomaly as representing adenopathy.