泌尿系统影像学英文版-瑞金医学影像学精品课.pptVIP

TUBERCULOSIS OF URINARY TRACT Secondary infection Hematogenous dissemination TUBERCULOSIS OF URINARY TRACT Pathology TB bacilli renal cortex infection medullary destruction caseous necrosis abscess (calcification) pelvicalyceal destruction ureter and bladder TB TUBERCULOSIS TUBERCULOSIS OF URINARY TRACT Auto-resection of kidney Diffused calcification of caseous foci, or whole kidney + loss of renal function Auto-resection of kidney Renal Tuberculosis TUBERCULOSIS OF URINARY TRACT KUB: ⑴ normal (early stage ) ⑵ calcification Renal Tuberculosis TUBERCULOSIS OF URINARY TRACT IVU: ⑴ calyceal destruction ⑵ abscess and cavity formation ⑶ pyonephrosis ⑷ diffuse fibrotic contraction and calcification ⑸ auto-resection of kidney Renal Tuberculosis Plain CT scans: ⑴ high density (calcification) ⑵ low density areas (abscess or cavity) ⑶ CT values: 20~40Hu(abscess) Renal Tuberculosis TUBERCULOSIS OF URINARY TRACT Contrast-enhanced CT scans: ⑴ low density areas without enhancement. ⑵ contrast media is demonstrable within the abscess. ⑶ pelvicalyceal enlargement Renal Tuberculosis TUBERCULOSIS OF URINARY TRACT MRI: ⑴ low signal on T1WI ⑵ high signal on T2WI Renal Tuberculosis TUBERCULOSIS OF URINARY TRACT TUBERCULOSIS OF URINARY TRACT Ureteral Tuberculosis KUB: calcification IVU: ⑴ stricture ⑵ shorten ⑶ beading TUBERCULOSIS OF URINARY BLADDER IVU: Small bladder Contracted bladder TUMORS OF URINARY TRACT Renal Carcinoma KUB: ⑴ kidney enlarged, local protrusion ⑵ calcification in 10% of patients IVU: ⑴ renal contour: bulging ⑵ calyces and pelvis: compression narrowing dissociation destruction Renal Carcinoma Plain CT scans: ⑴ mass (20~50Hu) ⑵ calcification ⑶ the tumor may be hypodense or isodense in comparison to the surrounding structures TUMORS OF URINARY TRACT Renal Carcinoma Contrast-enhanced CT scans: ⑴ inhomogeneous enhancement ⑵ peripheral enhancement ⑶ non-enhanced necro