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Uroradiology for the Clinician

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Renal Cell Carcinoma

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CT with contrast; Mass enhancement, heterogeneity with necrosis or hemorrhage, possible renal vein involvement.

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Polycystic Kidney Disease

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Ultrasound; Enlarged kidneys with numerous cysts of varying sizes.

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Renal Abscess

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Ultrasound or CT; Complex fluid collection within the kidney, may have detectable gas formation.

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Vesicoureteral Reflux (VUR)

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Voiding Cystourethrography (VCUG); Retrograde flow of urine from bladder to ureters and kidneys.

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Renal Vein Thrombosis

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Doppler Ultrasound or CT/MR Venography; Absence of flow in the renal vein, thrombus visualization.

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Hydronephrosis

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Ultrasound; Dilated renal pelvis and calyces, may show slowed or reversed diastolic flow on Doppler US.

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Urinary Tract Infection (UTI)

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Ultrasound or CT without contrast; May show thickened bladder walls and ureteral dilation.

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Glomerulonephritis

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Ultrasound; Increased renal cortical echogenicity and possibly thickened glomerular basement membrane.

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Wilms Tumor

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Ultrasound and CT; Large, lobulated renal mass in children, may show intratumoral cysts on US, heterogeneous enhancement on CT.

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Kidney - Normal Anatomy

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Ultrasound; Shows kidney size, cortical thickness, and echogenicity.

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Nephrocalcinosis

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X-ray or CT without contrast; Diffuse renal parenchymal calcifications, more visible on CT.

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Renal Cyst

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Ultrasound or CT; Simple cysts are anechoic with thin walls on US, and have a characteristic water density without enhancement on CT.

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Renal Trauma

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CT with contrast; Lacerations, contusions, hematomas, or active bleeding within or around the kidneys.

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Ureteral Obstruction

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CT urography or Ultrasound; Delayed excretion of contrast, hydronephrosis, and tapering of the ureter at the site of obstruction.

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Urethral Stricture

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Retrograde urethrography or Urethroscopy; Narrowing of the urethral lumen with pre-stricture dilation and post-void residual urine.

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Renal Artery Aneurysm

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CT Angiography or MR Angiography; Saccular or fusiform dilatation of the renal artery, may contain thrombus or calcification.

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Interstitial Cystitis

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MRI or Cystoscopy; Thickening of the bladder wall, submucosal fibrosis, and mast cell infiltration.

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Acute Pyelonephritis

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CT with contrast; Striated nephrogram, blurring of renal outline, and possibly perirenal stranding.

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Pelvic Kidney

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Ultrasound or CT; Kidney location in the pelvis, possibly with altered vascular supply.

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Renal Artery Stenosis

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Doppler Ultrasound or CT Angiography; Narrowing of the renal artery, turbulent flow on US, or stenosis on CTA.

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Bladder Diverticulum

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Cystography or CT Urography; Outpouching of the bladder wall, and filling with contrast.

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Prostate Enlargement (BPH)

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Ultrasound or MRI; Enlarged prostate with homogenous texture on US, can assess zonal anatomy better with MRI.

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Urolithiasis (Ureter)

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CT without contrast; Stone within the ureter, possible hydronephrosis if obstruction is present.

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Ureterocele

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Ultrasound or CT Urography; Cystic dilation of the distal ureter into the bladder lumen.

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Renal Stone (Nephrolithiasis)

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Non-contrast CT of the abdomen and pelvis; Shows hyperdense calculi usually within the urinary tract.

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Bladder Cancer

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CT urography; Irregular bladder wall thickening or mass, may enhance post-contrast.

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