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Uroradiology for the Clinician
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Renal Cell Carcinoma
CT with contrast; Mass enhancement, heterogeneity with necrosis or hemorrhage, possible renal vein involvement.
Polycystic Kidney Disease
Ultrasound; Enlarged kidneys with numerous cysts of varying sizes.
Renal Abscess
Ultrasound or CT; Complex fluid collection within the kidney, may have detectable gas formation.
Vesicoureteral Reflux (VUR)
Voiding Cystourethrography (VCUG); Retrograde flow of urine from bladder to ureters and kidneys.
Renal Vein Thrombosis
Doppler Ultrasound or CT/MR Venography; Absence of flow in the renal vein, thrombus visualization.
Hydronephrosis
Ultrasound; Dilated renal pelvis and calyces, may show slowed or reversed diastolic flow on Doppler US.
Urinary Tract Infection (UTI)
Ultrasound or CT without contrast; May show thickened bladder walls and ureteral dilation.
Glomerulonephritis
Ultrasound; Increased renal cortical echogenicity and possibly thickened glomerular basement membrane.
Wilms Tumor
Ultrasound and CT; Large, lobulated renal mass in children, may show intratumoral cysts on US, heterogeneous enhancement on CT.
Kidney - Normal Anatomy
Ultrasound; Shows kidney size, cortical thickness, and echogenicity.
Nephrocalcinosis
X-ray or CT without contrast; Diffuse renal parenchymal calcifications, more visible on CT.
Renal Cyst
Ultrasound or CT; Simple cysts are anechoic with thin walls on US, and have a characteristic water density without enhancement on CT.
Renal Trauma
CT with contrast; Lacerations, contusions, hematomas, or active bleeding within or around the kidneys.
Ureteral Obstruction
CT urography or Ultrasound; Delayed excretion of contrast, hydronephrosis, and tapering of the ureter at the site of obstruction.
Urethral Stricture
Retrograde urethrography or Urethroscopy; Narrowing of the urethral lumen with pre-stricture dilation and post-void residual urine.
Renal Artery Aneurysm
CT Angiography or MR Angiography; Saccular or fusiform dilatation of the renal artery, may contain thrombus or calcification.
Interstitial Cystitis
MRI or Cystoscopy; Thickening of the bladder wall, submucosal fibrosis, and mast cell infiltration.
Acute Pyelonephritis
CT with contrast; Striated nephrogram, blurring of renal outline, and possibly perirenal stranding.
Pelvic Kidney
Ultrasound or CT; Kidney location in the pelvis, possibly with altered vascular supply.
Renal Artery Stenosis
Doppler Ultrasound or CT Angiography; Narrowing of the renal artery, turbulent flow on US, or stenosis on CTA.
Bladder Diverticulum
Cystography or CT Urography; Outpouching of the bladder wall, and filling with contrast.
Prostate Enlargement (BPH)
Ultrasound or MRI; Enlarged prostate with homogenous texture on US, can assess zonal anatomy better with MRI.
Urolithiasis (Ureter)
CT without contrast; Stone within the ureter, possible hydronephrosis if obstruction is present.
Ureterocele
Ultrasound or CT Urography; Cystic dilation of the distal ureter into the bladder lumen.
Renal Stone (Nephrolithiasis)
Non-contrast CT of the abdomen and pelvis; Shows hyperdense calculi usually within the urinary tract.
Bladder Cancer
CT urography; Irregular bladder wall thickening or mass, may enhance post-contrast.
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