泌尿系统影像学 Uroradiology.pptx

泌尿系统影像诊断学Uroradiology;Outline;Contrast in urinary system;Urinary system;Urinary system: X-ray contrast;Imaging modalities for urinary system; Plane film（KUB） -good for positive stones Ultrasound -real time, convenient, low cost, available  -good characteristic of stone, fluid Urography Intravenous pyelography Retrograde pyelography Cystography Urethrography  -show morphous of the lumen indirectly  -overall view of the urinary tract  -affected by the renal function lumen construction CT -high resolution of high density low density  -contrast enhancement MRI  -good contrast of soft tissues ;KUB/CT plain scan; IVP –compress the ureter, picture 15’-30’ after contrast administration ;Retrograde pyelogram/MRU;Contrast enhancement;CT+C;CT+C;MRI;CTU vs. MRU;CTA vs. MRA;Imaging of some diseases;;; USG: high specific but low sensitive with ureter calculi KUB: renal calculi-pelvic/calix (staghorn stone)  ureter calculi-? CT: high sensitive, exact positioning 90% X-ray positive, diagnose considering clinical data;Urinary tract stones;;;;;;;;;;; Pathologic features correlated to imaging thin, even wall flat epithelium clear fluid inside no blood flow; Plain film: profile changing Urography: pelvix calix deforming, no specific BUS： anechoic lesion, high specific CT： clear appearance, high sen. spe. for calcification of the wall or septation MRI：cystic, signal of fluids,  different diagnosis needed if signal be  non-specific;;;;;;Pathologic features correlated to imaging neoplasm-mass effect neoplastic vascularity necrosis bleeding inside the mass; Plain film: profile change-helpless with diagnosis Urography: elongated deformed pelvic-poor specificity BUS: substantial, hypo/inhomogeneous echoic region Angiography: vessel shift, tumor stain, neovasculature CT: high specific sensitive in diagnosis and staging MRI: substitute for CT in diagnosis and staging;;