Quaia Radiological Imaging of the Kidney

1. Auflage 2011
ISBN: 978-3-540-87597-0
Verlag: Springer-Verlag
Format: PDF
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, 914 Seiten

This book provides a unique and comprehensive analysis of the normal anatomy and pathology of the kidney and upper urinary tract from the modern diagnostic imaging point of view. The first part is dedicated to the normal radiological anatomy of the kidney and normal anatomic variants. The second part presents in detail all of the imaging modalities which can be employed to assess the kidney and the upper urinary tract, with careful descriptions of patient preparation, investigation protocols, and principal fields of application of each imaging modality. The entire spectrum of kidney pathologies is then presented with the aid of a large set of images, many of which are in color. The latest innovations in interventional radiology, biopsy procedures, and parametric and molecular imaging are also described. This book should be of great interest to all radiologists, oncologists, and urologists who are involved in the management of kidney pathologies in their daily clinical practice.

Autoren/Hrsg.

Quaia, Emilio

Inhaltsverzeichnis

1;Radiological Imaging of the Kidney;3
1.1;Dedication;5
1.2;Foreword;6
1.3;Preface;7
1.4;Contents;8
1.5;Part I:Embryology and Anatomy;11
1.5.1;1: Embryology of the Kidney;12
1.5.1.1;1.1 Introduction;12
1.5.1.2;1.2 Development of Urogenital System;13
1.5.1.3;1.3 Development of Urinary System;13
1.5.1.3.1;1.3.1 Morphogenesis of Transient Kidney;14
1.5.1.3.1.1;1.3.1.1 Pronephroi;14
1.5.1.3.1.2;1.3.1.2 Mesonephroi;14
1.5.1.3.2;1.3.2 Morphogenesis of Metanephros or Permanent Kidney;16
1.5.1.4;1.4 Migration of the Kidneys;18
1.5.1.5;1.5 Lobes of Kidney Surface;19
1.5.1.6;1.6 Vascular Variations;19
1.5.1.7;1.7 Supernumerary Renal Arteries;19
1.5.1.8;1.8 Molecular Aspects of Kidney Development;19
1.5.1.8.1;1.8.1 Inductive Processes and Proliferation;19
1.5.1.8.2;1.8.2 Apoptosis;21
1.5.1.9;1.9 Congenital Abnormalities of the Kidney and Urinary Tract;21
1.5.1.9.1;1.9.1 Renal Agenesis (Fig. 1.7a);21
1.5.1.9.2;1.9.2 Hypoplastic Kidney;21
1.5.1.9.3;1.9.3 Ectopic Kidney (Fig. 1.7b–e);21
1.5.1.9.4;1.9.4 Fused/Horseshoe Kidney;23
1.5.1.9.5;1.9.5 Ectopic Ureter;23
1.5.1.9.6;1.9.6 Duplications of the Urinary Tract;23
1.5.1.9.7;1.9.7 Wilms Tumor;23
1.5.1.10;1.10 Conclusions;23
1.5.1.11;References;24
1.5.2;2: Normal Radiological Anatomy and Anatomical Variants of the Kidney;25
1.5.2.1;2.1 Anatomy and Physiology of the Kidney;25
1.5.2.1.1;2.1.1 Normal Renal Anatomy;25
1.5.2.1.1.1;2.1.1.1 Macroscopic Renal Anatomy;25
1.5.2.1.1.2;2.1.1.2 Microscopic Renal Anatomy and Nephron Physiology;29
1.5.2.1.2;2.1.2 Normal Renal Physiology;32
1.5.2.1.3;2.1.3 Calculation of Glomerular Filtration Rate (GFR);33
1.5.2.1.4;2.1.4 Calculation of Glomerular Filtration Rate (GFR) in Acute Renal Failure;36
1.5.2.2;2.2 Normal Radiological Anatomy of the Renal Parenchyma, Intrarenal Vasculature, and Anatomical Variants;37
1.5.2.2.1;2.2.1 Conventional Radiography;37
1.5.2.2.2;2.2.2 Gray-Scale and Doppler Ultrasound;38
1.5.2.2.3;2.2.3 Computed Tomography;41
1.5.2.2.4;2.2.4 Magnetic Resonance Imaging;44
1.5.2.2.5;2.2.5 Anatomical Variants of Renal Morphology;45
1.5.2.2.6;2.2.6 Anatomical Variants of Renal Parenchyma;47
1.5.2.3;2.3 Normal Radiological Anatomy of Renal Vessels and Anatomical Variants;52
1.5.2.3.1;2.3.1 Gray-Scale and Doppler Ultrasound;54
1.5.2.3.2;2.3.2 CT Angiography;54
1.5.2.3.3;2.3.3 MR Angiography;56
1.5.2.3.4;2.3.4 Anatomical Variants of Renal Vessels;57
1.5.2.4;2.4 Normal Radiological Anatomy of the Urinary Tract and Anatomical Variants;62
1.5.2.4.1;2.4.1 Excretory Urography and Anterograde and Retrograde Pyelography;62
1.5.2.4.2;2.4.2 CT Urography;63
1.5.2.4.3;2.4.3 Magnetic Resonance Imaging and MR Urography;63
1.5.2.4.4;2.4.4 Anatomical Variants of the Urinary Tract;67
1.5.2.5;2.5 Appendix: Basic Morphological Changes of the Intrarenal Urinary Tract Visible on Intravenous Excretory Urography and Mult;76
1.5.2.6;References;84
1.5.3;3: Normal Radiological Anatomy of the Retroperitoneum;86
1.5.3.1;3.1 Normal Anatomy of Retroperitoneum;86
1.5.3.2;References;90
1.6;Part II:Imaging and Interventional Modalities;91
1.6.1;4: Ultrasound of the Kidney;92
1.6.1.1;4.1 Technology;93
1.6.1.2;4.2 Ultrasound Scanning Technique of the Kidneys;95
1.6.1.2.1;4.2.1 Gray-Scale Ultrasound;95
1.6.1.2.1.1;4.2.1.1 Normal Anatomy;95
1.6.1.2.1.2;4.2.1.2 Fundamental Alterations of Renal Echogenicity;97
1.6.1.2.1.3;4.2.1.3 Solid and Cystic Renal Tumors;98
1.6.1.2.2;4.2.2 Color and Power Doppler Ultrasound;106
1.6.1.2.2.1;4.2.2.1 Normal Anatomy;106
1.6.1.2.2.2;4.2.2.2 Fundamental Alterations of Renal Parenchyma Vascularity;108
1.6.1.2.2.3;4.2.2.3 Renal Tumors;109
1.6.1.2.2.4;4.2.2.4 Assessment of Renal Vessels;111
1.6.1.3;4.3 Clinical Indications for Renal Ultrasound Examination;116
1.6.1.4;4.4 Microbubble Contrast Agents and Contrast-Specific Ultrasound Techniques;117
1.6.1.4.1;4.4.1 Chemical Composition of Microbubble Contrast Agents;118
1.6.1.4.2;4.4.2 Safety;119
1.6.1.4.3;4.4.3 Insonation Power;120
1.6.1.4.4;4.4.4 Contrast-Specific Ultrasound Techniques;120
1.6.1.5;4.5 Dynamic Phases After Microbubble Injection in the Kidney;123
1.6.1.5.1;4.5.1 Dynamic Phases;123
1.6.1.5.2;4.5.2 Microbubble Artifacts;123
1.6.1.6;4.6 Clinical Applications of Microbubble Contrast Agents in the Kidney;124
1.6.1.7;References;130
1.6.2;5: Computed Tomography;133
1.6.2.1;5.1 General Concepts;133
1.6.2.1.1;5.1.1 Technical Parameters;135
1.6.2.1.1.1;5.1.1.1 Imaging;135
1.6.2.1.1.2;5.1.1.2 Artifacts;137
1.6.2.1.1.3;5.1.1.3 Radiation Dose;140
1.6.2.1.2;5.1.2 Unenhanced and Contrast-Enhanced CT;143
1.6.2.1.2.1;5.1.2.1 Patient Preparation;143
1.6.2.1.2.2;5.1.2.2 Unenhanced CT;143
1.6.2.1.2.2.1;Precontrast Scan;143
1.6.2.1.2.2.2;Renal Colic (Acute Flank Pain);144
1.6.2.1.2.3;5.1.2.3 Contrast-Enhanced CT;148
1.6.2.1.2.3.1;CT Examination of Renal Masses;151
1.6.2.1.2.3.2;CT Examination of Renal Traumas;154
1.6.2.1.2.3.3;CT Examination of the Postoperative Kidney;157
1.6.2.1.3;5.1.3 CT Nephrogram Alterations;157
1.6.2.1.3.1;5.1.3.1 Delayed CT Nephrogram;158
1.6.2.1.3.2;5.1.3.2 Increased Density of CT Nephrogram;158
1.6.2.1.3.3;5.1.3.3 Decreased Density or Absence of CT Nephrogram;158
1.6.2.1.3.4;5.1.3.4 Cortical (Rim) Nephrogram;162
1.6.2.2;5.2 Multidetector CT Urography and CT Angiography;164
1.6.2.2.1;5.2.1 Multidetector CT Urography;165
1.6.2.2.1.1;5.2.1.1 Technique;165
1.6.2.2.1.2;5.2.1.2 Optimizing Excretory Phase;167
1.6.2.2.1.3;5.2.1.3 Reconstruction Algorithms;170
1.6.2.2.1.4;5.2.1.4 Radiation Dose;170
1.6.2.2.1.5;5.2.1.5 Indications;174
1.6.2.2.2;5.2.2 CT Angiography;176
1.6.2.2.3;5.2.3 Dual-Energy CT;177
1.6.2.3;References;178
1.6.3;6: Magnetic Resonance Imaging of the Kidney;182
1.6.3.1;6.1 Technique;183
1.6.3.1.1;6.1.1 Equipment;183
1.6.3.1.2;6.1.2 Patient Positioning;183
1.6.3.1.3;6.1.3 Breath Holding;183
1.6.3.1.4;6.1.4 Sequences;183
1.6.3.2;6.2 Magnetic Resonance Appearance of Renal Diseases;187
1.6.3.2.1;6.2.1 Renal Cell Carcinoma;187
1.6.3.2.2;6.2.2 Urothelial Carcinoma;189
1.6.3.2.3;6.2.3 Lymphoma;190
1.6.3.2.4;6.2.4 Metastasis;190
1.6.3.2.5;6.2.5 Angiomyolipoma;190
1.6.3.2.6;6.2.6 Oncocytoma;191
1.6.3.2.7;6.2.7 Other Benign Renal Masses;191
1.6.3.2.8;6.2.8 Cystic Lesions;191
1.6.3.2.9;6.2.9 Renal Infections;194
1.6.3.2.10;6.2.10 Renal Artery Stenosis;195
1.6.3.3;6.3 Renal Transplant;195
1.6.3.4;6.4 Advanced Applications;196
1.6.3.4.1;6.4.1 Magnetic Resonance Angiography Without Gadolinium-Based Contrast Administration;196
1.6.3.4.2;6.4.2 Contrast-Enhanced Magnetic Resonance Renography;196
1.6.3.4.3;6.4.3 Diffusion MRI and Renal Function;197
1.6.3.4.4;6.4.4 BOLD MRI;197
1.6.3.4.5;6.4.5 USPIO Particles;197
1.6.3.5;References;198
1.6.4;7: Renal Angiography and vascular interventional radiology;199
1.6.4.1;7.1 Introduction;199
1.6.4.2;7.2 Technique;200
1.6.4.2.1;7.2.1 Diagnostic Angiography;200
1.6.4.3;7.3 Interventional Renal Vascular Procedures;203
1.6.4.3.1;7.3.1 Vascular Interventions;203
1.6.4.3.2;7.3.2 Other Endovascular Interventions;206
1.6.4.3.3;7.3.3 Renal Phlebography;208
1.6.4.4;7.4 Anatomy and Variants;208
1.6.4.4.1;7.4.1 Arteries;208
1.6.4.4.2;7.4.2 Veins;211
1.6.4.5;7.5 Occlusive Disease;211
1.6.4.5.1;7.5.1 Atherosclerotic Renal Artery;212
1.6.4.5.1.1;7.5.1.1 Endovascular Treatment of Atherosclerotic Renal Artery Stenosis;215
1.6.4.5.2;7.5.2 Fibromuscular Dysplasia (FMD);215
1.6.4.5.2.1;7.5.2.1 FMD, Variants, and Appearance on Angiography;215
1.6.4.5.2.2;7.5.2.2 Endovascular Treatment of FMD;219
1.6.4.5.3;7.5.3 Other Causes;219
1.6.4.6;7.6 Acute Renal Ischemia;219
1.6.4.6.1;7.6.1 Renal Vein Thrombosis;220
1.6.4.7;7.7 Renal Artery Aneurysms;220
1.6.4.8;7.8 Arteriovenous Fistulas;222
1.6.4.9;7.9 Trauma;223
1.6.4.10;7.10 Renal Transplantation;223
1.6.4.11;7.11 Neoplasms;225
1.6.4.11.1;7.11.1 Benign Tumors;225
1.6.4.11.1.1;7.11.1.1 Angiomyolipoma (AML);225
1.6.4.11.1.2;7.11.1.2 Oncocytoma;225
1.6.4.11.2;7.11.2 Malignant Tumors;225
1.6.4.11.2.1;7.11.2.1 Advanced Renal Cell Carcinomas;225
1.6.4.11.2.2;7.11.2.2 Malignant Lesions;227
1.6.4.12;References;227
1.6.5;8: Nuclear Medicine;230
1.6.5.1;8.1 Introduction;230
1.6.5.2;8.2 Renal Nuclear Medicine Principles;231
1.6.5.2.1;8.2.1 Radiopharmaceuticals;232
1.6.5.2.1.1;8.2.1.1 Glomerular-Filtered Agents;232
1.6.5.2.1.2;8.2.1.2 Tubular Excreted Agents;233
1.6.5.2.1.3;8.2.1.3 Cortical Agents;233
1.6.5.2.1.4;8.2.1.4 Oncological Tracers;234
1.6.5.2.2;8.2.2 Principal Investigations;234
1.6.5.2.2.1;8.2.2.1 Blood Sampling;234
1.6.5.2.2.2;8.2.2.2 Dynamic Renal Scintigraphy;235
1.6.5.2.2.2.1;Diuretic Scintigraphy;236
1.6.5.2.2.2.2;Quantitative Methods;237
1.6.5.2.2.3;8.2.2.3 Static Renal Scintigraphy;237
1.6.5.2.2.4;8.2.2.4 Radionuclide Cystography;238
1.6.5.3;8.3 Clinical Applications;238
1.6.5.3.1;8.3.1 Renal Failure;241
1.6.5.3.2;8.3.2 Urinary Tract Dilatation;244
1.6.5.3.3;8.3.3 Urinary Tract Infection;246
1.6.5.3.4;8.3.4 Renovascular Hypertension;247
1.6.5.3.5;8.3.5 Renal Transplantation;249
1.6.5.3.6;8.3.6 Renal Cancer;252
1.6.5.4;References;254
1.6.6;9: The Role of Kidney Biopsy in the Diagnosis of Renal Disease and Renal Masses;257
1.6.6.1;9.1 Introduction;258
1.6.6.2;9.2 Historical Background;258
1.6.6.3;9.3 Clinical Indications for Renal Biopsy;259
1.6.6.3.1;9.3.1 Major Indications;259
1.6.6.3.1.1;9.3.1.1 Idiopathic Nephrotic Syndrome;259
1.6.6.3.1.2;9.3.1.2 Acute Renal Injury;260
1.6.6.3.1.3;9.3.1.3 Renal Allograft Dysfunction;260
1.6.6.3.2;9.3.2 Optional Indications;260
1.6.6.3.2.1;9.3.2.1 Persistent Nonnephrotic Proteinuria;260
1.6.6.3.2.2;9.3.2.2 Isolated Glomerular Hematuria;261
1.6.6.3.2.3;9.3.2.3 Chronic Kidney Injury;261
1.6.6.4;9.4 Contraindications to the Renal Biopsy;261
1.6.6.5;9.5 The Preparation of the Patient for Renal Biopsy;262
1.6.6.5.1;9.5.1 The Patient Before the Biopsy;262
1.6.6.6;9.6 The Biopsy Procedure;263
1.6.6.6.1;9.6.1 The Choice of the Biopsy Site;263
1.6.6.6.2;9.6.2 Biopsy Needle Types;263
1.6.6.6.3;9.6.3 Evaluation and Division of the Biopsy Tissue;264
1.6.6.6.4;9.6.4 Fixatives for Preservation of the Biopsy Tissue;264
1.6.6.7;9.7 Percutaneous Biopsy of Renal Masses;264
1.6.6.7.1;9.7.1 Indications;264
1.6.6.7.2;9.7.2 Technique;265
1.6.6.7.3;9.7.3 Results;267
1.6.6.8;9.8 Renal Biopsy Complications and Follow-Up;267
1.6.6.9;References;269
1.6.7;10: Nonvascular Interventional Radiology Procedures;271
1.6.7.1;10.1 Introduction;272
1.6.7.2;10.2 Imaging Modalities and Interventional Equipment;272
1.6.7.2.1;10.2.1 Imaging Modalities;272
1.6.7.2.1.1;10.2.1.1 Fluoroscopy;272
1.6.7.2.1.2;10.2.1.2 Ultrasonography;273
1.6.7.2.1.3;10.2.1.3 CT;273
1.6.7.2.1.4;10.2.1.4 Interventional MRI;274
1.6.7.2.2;10.2.2 Interventional Equipment Tools;274
1.6.7.2.2.1;10.2.2.1 Needles;274
1.6.7.2.2.2;10.2.2.2 Guidewires;275
1.6.7.2.2.3;10.2.2.3 Catheters;275
1.6.7.3;10.3 Renal Biopsy;275
1.6.7.3.1;10.3.1 Indications;275
1.6.7.4;10.4 US- and CT-Guided Drainage of Renal and Perirenal Collections;277
1.6.7.4.1;10.4.1 Indications;277
1.6.7.4.2;10.4.2 Preparation;277
1.6.7.4.3;10.4.3 Techniques;277
1.6.7.4.4;10.4.4 Success Rate;278
1.6.7.4.5;10.4.5 Complications;279
1.6.7.5;10.5 Percutaneous Nephrostomy;279
1.6.7.5.1;10.5.1 Indications;279
1.6.7.5.2;10.5.2 Preparation;279
1.6.7.5.3;10.5.3 Technique;279
1.6.7.5.4;10.5.4 Success Rate;279
1.6.7.5.5;10.5.5 Complications;279
1.6.7.6;10.6 Percutaneous Lithotripsy and Nephrolithotomy;280
1.6.7.6.1;10.6.1 Indications;280
1.6.7.6.2;10.6.2 Preparation;280
1.6.7.6.3;10.6.3 Technique;280
1.6.7.6.4;10.6.4 Success Rate;281
1.6.7.6.5;10.6.5 Complications;281
1.6.7.7;10.7 Ureteral Stenting;281
1.6.7.7.1;10.7.1 Indications;281
1.6.7.7.2;10.7.2 Preparation;281
1.6.7.7.3;10.7.3 Techniques;281
1.6.7.7.4;10.7.4 Success Rate;282
1.6.7.7.5;10.7.5 Complications;283
1.6.7.8;10.8 Ureteral Ballooning of Strictures;283
1.6.7.8.1;10.8.1 Indications;283
1.6.7.8.2;10.8.2 Preparation;283
1.6.7.8.3;10.8.3 Techniques;283
1.6.7.8.4;10.8.4 Success Rate;283
1.6.7.8.5;10.8.5 Complications;283
1.6.7.9;10.9 Ureteral Embolization;284
1.6.7.9.1;10.9.1 Indications;284
1.6.7.9.2;10.9.2 Preparation;284
1.6.7.9.3;10.9.3 Techniques;284
1.6.7.9.4;10.9.4 Success Rate;285
1.6.7.9.5;10.9.5 Complications;285
1.6.7.10;10.10 Sovrapubic Tube Placement;285
1.6.7.10.1;10.10.1 Indications;285
1.6.7.10.2;10.10.2 Preparation;286
1.6.7.10.3;10.10.3 Techniques;286
1.6.7.10.4;10.10.4 Success Rate;286
1.6.7.10.5;10.10.5 Complications;286
1.6.7.10.6;10.10.6 Conclusion;286
1.6.7.11;References;286
1.7;Part III:Non-Tumoral Pathology;288
1.7.1;11: Congenital and Development Disorders of the Kidney;289
1.7.1.1;11.1 Embryology of the Kidneys, Ureters and Bladder;289
1.7.1.2;11.2 Positional and Fusion Anomalies;290
1.7.1.2.1;11.2.1 Ectopic Kidney;290
1.7.1.2.2;11.2.2 Horseshoe Kidneys;290
1.7.1.2.3;11.2.3 Crossed Fused Ectopia;291
1.7.1.3;11.3 Renal Agenesis and Anomalies in Size;291
1.7.1.3.1;11.3.1 Renal Agenesis;291
1.7.1.3.2;11.3.2 Renal Hypoplasia;293
1.7.1.4;11.4 Renal Cystic Disease;293
1.7.1.4.1;11.4.1 Renal Cystic Disease of Developmental Origin;293
1.7.1.4.1.1;11.4.1.1 Multicystic Dysplastic Kidney;293
1.7.1.4.1.2;11.4.1.2 Cystic Renal Dysplasia;295
1.7.1.4.2;11.4.2 Renal Cystic Disease of Genetic Origin;295
1.7.1.4.2.1;11.4.2.1 Autosomal Recessive Polycystic Kidney Disease;295
1.7.1.4.2.2;11.4.2.2 Autosomal Dominant Polycystic Kidney Disease;297
1.7.1.4.2.3;11.4.2.3 Medullary Cystic Disease and Nephronophthisis;297
1.7.1.4.2.4;11.4.2.4 Glomerulocystic Kidney Disease;298
1.7.1.5;11.5 Renal Tract Dilatation;299
1.7.1.5.1;11.5.1 Renal Pelvis Dilatation;299
1.7.1.5.2;11.5.2 Renal Pelvis and Ureter Dilatation;300
1.7.1.5.3;11.5.3 Duplex Kidney with Ureter Dilatation;302
1.7.1.5.4;11.5.4 Posterior Urethral Valves;304
1.7.1.5.5;11.5.5 Prune Belly Syndrome;304
1.7.1.6;11.6 Congenital Renal Tumours;306
1.7.1.7;References;307
1.7.2;12: Renal Cystic Disease;309
1.7.2.1;12.1 Introduction;309
1.7.2.2;12.2 Simple Cysts;312
1.7.2.3;12.3 Complex Cysts;313
1.7.2.4;12.4 Extraparenchymal Renal Sinus Cysts;315
1.7.2.5;12.5 Localized Cystic Disease;318
1.7.2.6;12.6 Acquired Cystic Kidney Disease;318
1.7.2.7;12.7 Polycystic Kidney Diseases;320
1.7.2.7.1;12.7.1 Autosomal Dominant Polycystic Kidney Disease;320
1.7.2.7.2;12.7.2 Autosomal Recessive Polycystic Kidney Disease;324
1.7.2.8;12.8 Renals Cysts in Hereditary Malformation Syndromes;324
1.7.2.8.1;12.8.1 Tuberous Sclerosis Complex;324
1.7.2.8.2;12.8.2 von Hippel–Lindau Disease;326
1.7.2.9;12.9 Medullary Sponge Kidney;326
1.7.2.10;12.10 Multicystic Dysplastic Kidney;328
1.7.2.11;12.11 Chronic Lithium Nephropathy;330
1.7.2.12;References;332
1.7.3;13: Renal Parenchymal and Inflammatory Diseases;336
1.7.3.1;13.1 Glomerulonephritis, Tubulo-Interstitial Nephritis, and Vasculitides;337
1.7.3.1.1;13.1.1 Glomerulonephritis and Tubulo-Interstitial Nephritis;338
1.7.3.1.2;13.1.2 Renal Vasculitides;339
1.7.3.2;13.2 Systemic Diseases Involving the Kidney;339
1.7.3.2.1;13.2.1 Diabetic Nephropathy;339
1.7.3.2.2;13.2.2 Hypertension;342
1.7.3.2.3;13.2.3 Lupus Systemic Erythematosus;343
1.7.3.2.4;13.2.4 Metabolic and Hematological Disease-Related Nephropathies;344
1.7.3.2.5;13.2.5 HIV-Associated Nephropathy;346
1.7.3.3;13.3 Drug Nephropathies;347
1.7.3.4;13.4 Pediatric Renal Parenchymal Diseases;347
1.7.3.5;13.5 Renal Medullary and Papillary Necrosis;348
1.7.3.6;References;353
1.7.4;14: Obstructive Uropathy, Pyonephrosis, and Reflux Nephropathy in Adults;354
1.7.4.1;14.1 Obstructive Uropathy;356
1.7.4.1.1;14.1.1 Imaging Findings;356
1.7.4.1.1.1;14.1.1.1 Ultrasound;356
1.7.4.1.1.2;14.1.1.2 Unenhanced Spiral CT;357
1.7.4.1.1.3;14.1.1.3 Intravenous Excretory Urography and CT Urography;358
1.7.4.1.1.4;14.1.1.4 MR Urography;361
1.7.4.1.2;14.1.2 Causes of Obstruction;363
1.7.4.1.2.1;14.1.2.1 Congenital Anomalies;363
1.7.4.1.2.2;14.1.2.2 Ureteropelvic Junction Obstruction;365
1.7.4.1.2.3;14.1.2.3 Urolithiasis and Acute Renal Colic;365
1.7.4.1.2.4;14.1.2.4 Other Benign Causes of Obstructive Uropathy;369
1.7.4.1.2.5;14.1.2.5 Malignancies Causing Obstructive Uropathy;376
1.7.4.1.3;14.1.3 Obstructive Nephropathy and Postrenal Acute Renal Failure;377
1.7.4.2;14.2 Pyonephrosis;378
1.7.4.3;14.3 Reflux Nephropathy in Adults;381
1.7.4.4;References;388
1.7.5;15: Nephrocalcinosis and Nephrolithiasis;391
1.7.5.1;15.1 Introduction;391
1.7.5.2;15.2 Nephrocalcinosis;392
1.7.5.2.1;15.2.1 Causes and Incidence of Nephrocalcinosis;392
1.7.5.2.2;15.2.2 Cortical Nephrocalcinosis;392
1.7.5.2.3;15.2.3 Medullary Nephrocalcinosis;394
1.7.5.2.3.1;15.2.3.1 Abnormal Calcium Metabolism;394
1.7.5.2.3.2;15.2.3.2 Renal Tubular Diseases;394
1.7.5.2.3.3;15.2.3.3 Medullary Sponge Kidney;395
1.7.5.3;15.3 Nephrolithiasis;395
1.7.5.3.1;15.3.1 Incidence and Epidemiology;397
1.7.5.3.1.1;15.3.1.1 Race and Sex;397
1.7.5.3.1.2;15.3.1.2 Age;397
1.7.5.3.1.3;15.3.1.3 Inherited Diseases;397
1.7.5.3.1.4;15.3.1.4 Individual Predisposing Factors;397
1.7.5.3.1.5;15.3.1.5 Environmental Factors;398
1.7.5.3.1.6;15.3.1.6 Socio-Economic Factors;398
1.7.5.3.1.7;15.3.1.7 Diet;398
1.7.5.3.2;15.3.2 Pathophysiology;398
1.7.5.3.3;15.3.3 Types of Calculi;398
1.7.5.3.3.1;15.3.3.1 Calcium Calculi;398
1.7.5.3.3.2;15.3.3.2 Cystine Stones;398
1.7.5.3.3.3;15.3.3.3 Struvite or Infective Calculi;399
1.7.5.3.3.4;15.3.3.4 Uric Acid Calculi;399
1.7.5.3.3.5;15.3.3.5 Xanthine Calculi;399
1.7.5.3.3.6;15.3.3.6 Matrix Calculi;399
1.7.5.3.3.7;15.3.3.7 Indinavir Calculi;400
1.7.5.3.3.8;15.3.3.8 Oxalate Calculi;400
1.7.5.4;15.4 Imaging;400
1.7.5.4.1;15.4.1 Background and Principles;400
1.7.5.4.2;15.4.2 Abdominal Radiographs;400
1.7.5.4.3;15.4.3 Intravenous Excretory Urography;401
1.7.5.4.4;15.4.4 Ultrasound;402
1.7.5.4.5;15.4.5 Computed Tomography;404
1.7.5.4.5.1;15.4.5.1 Unenhanced CT;405
1.7.5.4.5.2;15.4.5.2 CT Urography;408
1.7.5.4.6;15.4.6 Other Techniques;409
1.7.5.5;References;410
1.7.6;16: Acute Renal Infections;412
1.7.6.1;16.1 Acute Bacterial Pyelonephritis;413
1.7.6.1.1;16.1.1 Clinical Features and Pathophysiology;413
1.7.6.1.2;16.1.2 Imaging;415
1.7.6.1.2.1;16.1.2.1 IVU;416
1.7.6.1.2.2;16.1.2.2 US;416
1.7.6.1.2.3;16.1.2.3 CT;418
1.7.6.1.2.4;16.1.2.4 Nuclear Medicine;420
1.7.6.1.2.5;16.1.2.5 MRI;425
1.7.6.2;16.2 Renal and Perinephric Abscess;430
1.7.6.2.1;16.2.1 Clinical Features and Pathophysiology;430
1.7.6.2.2;16.2.2 Imaging;431
1.7.6.3;16.3 Gas-Forming Renal Infections;433
1.7.6.3.1;16.3.1 Emphysematous Pyelonephritis;434
1.7.6.3.2;16.3.2 Emphysematous Pyelitis;436
1.7.6.4;References;437
1.7.7;17: Chronic Renal Infections and Renal Fungal Infections;440
1.7.7.1;17.1 Chronic Pyelonephritis;441
1.7.7.2;17.2 Renal Tuberculosis;443
1.7.7.3;17.3 Xanthogranulomatous Pyelonephritis;445
1.7.7.4;17.4 Renal Replacement Lipomatosis;450
1.7.7.5;17.5 Renal Malacoplakia;451
1.7.7.6;17.6 Cholesteatoma;456
1.7.7.7;17.7 Renal Infections in AIDS Patients;456
1.7.7.8;17.8 Renal Fungal Infections;459
1.7.7.9;References;468
1.7.8;18: Renal Vascular Abnormalities;469
1.7.8.1;18.1 Renal Vascular Abnormalities;469
1.7.8.2;18.2 Arterial Disease;470
1.7.8.2.1;18.2.1 Renovascular Hypertension;470
1.7.8.2.1.1;18.2.1.1 Atherosclerosis;470
1.7.8.2.2;18.2.2 Renal Artery Stenosis (RAS);470
1.7.8.2.2.1;18.2.2.1 Fibromuscular Dysplasia;471
1.7.8.2.2.2;18.2.2.2 Takayasu’s Aortitis;473
1.7.8.2.2.3;18.2.2.3 Neurofibromatosis;473
1.7.8.2.2.4;18.2.2.4 Middle Aortic Syndrome;473
1.7.8.3;18.3 Diseases of the Intrarenal Arteries;474
1.7.8.3.1;18.3.1 Polyarteritis Nodosa (PAN);474
1.7.8.3.2;18.3.2 Wegener’s Granulomatosis;474
1.7.8.3.3;18.3.3 Systemic Lupus Erythematosus (SLE);474
1.7.8.3.4;18.3.4 Intravenous Drug Abuse;474
1.7.8.3.5;18.3.5 Scleroderma;475
1.7.8.3.6;18.3.6 Radiation Nephritis;475
1.7.8.3.7;18.3.7 Embolism and Infarction;475
1.7.8.3.8;18.3.8 Arterial Thrombosis;475
1.7.8.3.9;18.3.9 Renal Artery Aneurysm;475
1.7.8.3.10;18.3.10 Arteriovenous Fistula and Malformations (AVF and AVM);476
1.7.8.4;18.4 Venous Disease;477
1.7.8.4.1;18.4.1 Renal Vein Thrombosis (RVT);477
1.7.8.4.2;18.4.2 Varicocele Formation;477
1.7.8.4.3;18.4.3 Gonadal Vein Thrombosis;478
1.7.8.4.4;18.4.4 Renal Lymphangiomatosis;478
1.7.8.5;References;478
1.7.9;19: Imaging of Renal Trauma;480
1.7.9.1;19.1 Renal Injury Overview;481
1.7.9.2;19.2 Hematuria and Hemodynamic Stability;481
1.7.9.3;19.3 Penetrating Renal Trauma;481
1.7.9.4;19.4 Renal Injury Grading;482
1.7.9.5;19.5 Injury Grading and Intervention;483
1.7.9.6;19.6 CT Findings of Renal Injury;483
1.7.9.6.1;19.6.1 Minor: Contusion – Laceration;483
1.7.9.6.2;19.6.2 Minor: Focal Renal Infarct;484
1.7.9.6.3;19.6.3 Minor: Subcapsular Hematoma;484
1.7.9.7;19.7 CT Finding of Major Renal Injury;484
1.7.9.7.1;19.7.1 Urine Leaks;485
1.7.9.7.2;19.7.2 Hematoma;486
1.7.9.7.3;19.7.3 Parenchymal Disruption;486
1.7.9.8;19.8 CT of Catastrophic Renal Injury;486
1.7.9.8.1;19.8.1 Vascular Injury;486
1.7.9.8.2;19.8.2 Bleeding;491
1.7.9.8.3;19.8.3 Collecting System Injury;491
1.7.9.9;19.9 Injury of the Abnormal Kidney;494
1.7.9.10;19.10 Imaging Findings and Management;495
1.7.9.11;19.11 Complications of Renal Injury;496
1.7.9.11.1;19.11.1 Persistent Urinoma;496
1.7.9.11.2;19.11.2 Hypertension;496
1.7.9.12;19.12 Conclusion;498
1.7.9.13;References;498
1.8;Part IV:Tumoral Pathology;500
1.8.1;20: Benign Solid Renal Tumors;501
1.8.1.1;20.1 Angiomyolipoma;504
1.8.1.2;20.2 Renal Cell Neoplasms;515
1.8.1.2.1;20.2.1 Oncocytoma;515
1.8.1.2.2;20.2.2 Renal Papillary Adenoma;519
1.8.1.3;20.3 Other Benign Solid Renal Tumors;521
1.8.1.3.1;20.3.1 Embryonal Metanephric Adenoma;521
1.8.1.3.2;20.3.2 Benign Solid Tumors in Phakomatoses;526
1.8.1.3.3;20.3.3 Arteriovenous Fistulas and Intra-Renal Vascular Malformations;528
1.8.1.3.4;20.3.4 Rare Solid Benign Tumors;529
1.8.1.4;References;532
1.8.2;21: Renal Cell Carcinoma;534
1.8.2.1;21.1 Introduction;535
1.8.2.2;21.2 Histopathological Subtypes;535
1.8.2.3;21.3 Imaging of Conventional (Clear Cell) Renal Cell Carcinoma;536
1.8.2.3.1;21.3.1 Plain Radiography;536
1.8.2.3.2;21.3.2 Intravenous Urography;537
1.8.2.3.3;21.3.3 Ultrasound;537
1.8.2.3.4;21.3.4 Computed Tomography;538
1.8.2.3.5;21.3.5 Magnetic Resonance Imaging;541
1.8.2.3.6;21.3.6 Positron Emission Tomography;542
1.8.2.3.7;21.3.7 Angiography;542
1.8.2.4;21.4 Imaging of Uncommon Renal Cell Carcinoma;544
1.8.2.4.1;21.4.1 Papillary Type;545
1.8.2.4.2;21.4.2 Chromophobe Cell Type;546
1.8.2.4.3;21.4.3 Collecting Duct Type;547
1.8.2.4.4;21.4.4 Medullary Type;547
1.8.2.4.5;21.4.5 Sarcomatoid Type;548
1.8.2.4.6;21.4.6 Hypovascular or Avascular Renal Cell Carcinoma;548
1.8.2.5;21.5 Hereditary Renal Cell Carcinoma;548
1.8.2.5.1;21.5.1 von Hippel-Lindau Disease;549
1.8.2.5.2;21.5.2 Hereditary Papillary Renal Cancer;550
1.8.2.5.3;21.5.3 Hereditary Leiomyoma Renal Cell Carcinoma;550
1.8.2.5.4;21.5.4 Birt-Hogg-Dubé Syndrome;550
1.8.2.5.5;21.5.5 Familial Renal Oncocytoma;550
1.8.2.5.6;21.5.6 Tuberous Sclerosis;550
1.8.2.6;21.6 Staging of Renal Cell Carcinoma;550
1.8.2.6.1;21.6.1 Imaging Modalities for Staging;550
1.8.2.6.2;21.6.2 Follow-Up Imaging;552
1.8.2.7;21.7 Imaging of Metastases and Recurrence;553
1.8.2.8;21.8 An Overview of Role of Biopsy and Interventional Techniques;554
1.8.2.8.1;21.8.1 Percutaneous Biopsy of Renal Masses;554
1.8.2.8.2;21.8.2 Radiofrequency Ablation;555
1.8.2.8.3;21.8.3 Transarterial Embolization;557
1.8.2.8.4;21.8.4 Nephron-Sparing Surgery;558
1.8.2.9;21.9 Conclusion;559
1.8.2.10;References;560
1.8.3;22: Rare and Secondary Tumors of the Kidney and Renal Pseudotumors;564
1.8.3.1;22.1 Secondary Tumors of the Kidney;564
1.8.3.1.1;22.1.1 General Features;565
1.8.3.1.2;22.1.2 Imaging Features and Differential Diagnosis;565
1.8.3.2;22.2 Other Rare Renal Tumors;566
1.8.3.2.1;22.2.1 Medullary Tumors;566
1.8.3.2.1.1;22.2.1.1 Collecting (Bellini) Duct Carcinoma (CDC);566
1.8.3.2.1.1.1;General Features and Pathogenesis;566
1.8.3.2.1.1.2;Imaging Features and Differential Diagnosis;566
1.8.3.2.1.2;22.2.1.2 Renal Medullary Carcinoma;568
1.8.3.2.1.2.1;General Features;568
1.8.3.2.1.2.2;Imaging Features and Differential Diagnosis;568
1.8.3.2.2;22.2.2 Juxtaglomerular Cell Tumor (Reninoma);568
1.8.3.2.3;22.2.3 Solitary Fibrous Tumor;569
1.8.3.2.4;22.2.4 Leukemia, Plasmocytoma, Castleman Disease and Lymphoma;570
1.8.3.2.4.1;22.2.4.1 Leukemia;570
1.8.3.2.4.2;22.2.4.2 Plasmacytoma;570
1.8.3.2.4.3;22.2.4.3 Castleman Disease;570
1.8.3.2.4.4;22.2.4.4 Lymphoma;570
1.8.3.2.5;22.2.5 Sarcoma;570
1.8.3.2.6;22.2.6 Rare Benign Mesenchymal Tumors of the Kidney;570
1.8.3.2.6.1;22.2.6.1 Renal Leiomyoma;570
1.8.3.2.6.2;22.2.6.2 Renal Lipoma;571
1.8.3.2.6.3;22.2.6.3 Renal Hemangioma;571
1.8.3.2.6.4;22.2.6.4 Renal Lymphangioma;571
1.8.3.2.7;22.2.7 Extraadrenal Myelolipoma;571
1.8.3.2.8;22.2.8 Mesoblastic Nephroma;571
1.8.3.2.9;22.2.9 Metanephric Adenoma (Nephrogenic Adenofibroma);572
1.8.3.2.10;22.2.10 Multilocular Cystic Tumor;572
1.8.3.2.11;22.2.11 Neuro-Endocrine Tumor (NET) of the Kidney;572
1.8.3.2.12;22.2.12 Extraintestinal GIST;573
1.8.3.3;22.3 Renal Pseudotumors;573
1.8.3.3.1;22.3.1 Infection;573
1.8.3.3.1.1;22.3.1.1 Classical Presentation;573
1.8.3.3.1.2;22.3.1.2 Xanthogranulomatous Pyelonephritis;575
1.8.3.3.1.3;22.3.1.3 Renal Tuberculosis;575
1.8.3.3.1.4;22.3.1.4 Renal Aspergillosis;576
1.8.3.3.1.5;22.3.1.5 Hydatid Cyst of the Kidney;577
1.8.3.3.2;22.3.2 Renal Malacoplakia;577
1.8.3.3.3;22.3.3 Renal Hematoma;577
1.8.3.3.4;22.3.4 Renal Sarcoidosis;577
1.8.3.3.5;22.3.5 Renal Amyloidosis;577
1.8.3.3.6;22.3.6 Renal Sinus Histocytosis;579
1.8.3.3.7;22.3.7 Systemic Lupus Erythematosus;579
1.8.3.3.8;22.3.8 Perirenal Fibrosis and Erdheim–Chester Disease;579
1.8.3.3.8.1;22.3.8.1 Perirenal Fibrosis;579
1.8.3.3.8.2;22.3.8.2 Erdheim–Chester Disease;579
1.8.3.3.9;22.3.9 Inflammatory Pseudotumor;580
1.8.3.3.10;22.3.10 Renal Sinus Lipomatosis;581
1.8.3.3.11;22.3.11 Extramedullary Hematopoiesis;581
1.8.3.3.12;22.3.12 Congenital and Acquired Pseudotumors;581
1.8.3.3.13;22.3.13 Vascular Anomalies;582
1.8.3.3.14;22.3.14 Hemorrhagic Cysts;582
1.8.3.4;References;583
1.8.4;23: Radiofrequency Ablation and Cryoablation for Renal Cell Carcinoma;585
1.8.4.1;23.1 Indications;586
1.8.4.2;23.2 Patient Selection;586
1.8.4.3;23.3 Procedure;587
1.8.4.3.1;23.3.1 Radiofrequency Ablation;587
1.8.4.3.2;23.3.2 Cryoablation;587
1.8.4.3.3;23.3.3 Emerging Technologies;588
1.8.4.3.4;23.3.4 Difficulties Comparing Modalities and Approaches;588
1.8.4.3.5;23.3.5 Adjuvant Therapy;589
1.8.4.3.6;23.3.6 Biopsy Controversy;589
1.8.4.3.7;23.3.7 Day of the Procedure;589
1.8.4.4;23.4 Outcomes and Complications;590
1.8.4.4.1;23.4.1 Imaging Follow-Up;590
1.8.4.4.2;23.4.2 Imaging Pitfalls;590
1.8.4.4.3;23.4.3 Outcomes;590
1.8.4.4.3.1;23.4.3.1 Outcomes for Radiofrequency Ablation;591
1.8.4.4.3.2;23.4.3.2 Outcomes for Cryoablation;591
1.8.4.4.4;23.4.4 Complications;592
1.8.4.5;23.5 Conclusion;593
1.8.4.6;References;593
1.8.5;24: Upper Urinary Tract Tumors;595
1.8.5.1;24.1 Pathology and Histology of Transitional Cell Carcinoma;596
1.8.5.2;24.2 Imaging;597
1.8.5.2.1;24.2.1 Imaging of Upper Tract Urinary Tumors;597
1.8.5.2.1.1;24.2.1.1 Ultrasonography;597
1.8.5.2.1.2;24.2.1.2 Intravenous Excretory Urography;598
1.8.5.2.1.3;24.2.1.3 Anterograde and Retrograde Pyelography;599
1.8.5.2.1.4;24.2.1.4 Multidetector CT Urography;601
1.8.5.2.1.5;24.2.1.5 CT;604
1.8.5.2.1.6;24.2.1.6 MR Imaging;607
1.8.5.2.2;24.2.2 Imaging of Hematuria;609
1.8.5.3;24.3 Staging of Upper Urinary Tract Tumors;613
1.8.5.4;24.4 Follow-Up;614
1.8.5.5;24.5 Other Malignant Tumors of the Upper Urinary Tract;614
1.8.5.6;24.6 Differential Diagnosis;615
1.8.5.7;24.7 Benign Tumors of the Upper Urinary Tract;616
1.8.5.8;References;618
1.8.6;25: Renal Lymphoma and Renal Sarcoma;621
1.8.6.1;25.1 Renal Lymphoma;622
1.8.6.1.1;25.1.1 General Features;622
1.8.6.1.2;25.1.2 Pathogenesis;622
1.8.6.1.3;25.1.3 Imaging Features and Differential Diagnosis;622
1.8.6.1.3.1;25.1.3.1 Multiple Masses;622
1.8.6.1.3.2;25.1.3.2 Retroperitoneal Extension;623
1.8.6.1.3.3;25.1.3.3 Infiltrative Disease;624
1.8.6.1.3.4;25.1.3.4 Solitary Mass;624
1.8.6.1.3.5;25.1.3.5 Perirenal Disease;624
1.8.6.1.3.6;25.1.3.6 Atypical Findings;625
1.8.6.1.4;25.1.4 Roll of Different Imaging Modalities;625
1.8.6.1.4.1;25.1.4.1 Ultrasound;625
1.8.6.1.4.2;25.1.4.2 Computed Tomography and Positron Emission Tomography-Computed Tomography (PET-CT);625
1.8.6.1.4.3;25.1.4.3 MRI;626
1.8.6.1.5;25.1.5 Diagnostic Approach;626
1.8.6.2;25.2 Renal Sarcoma;626
1.8.6.2.1;25.2.1 General Features;626
1.8.6.2.2;25.2.2 Pathogenesis;626
1.8.6.2.3;25.2.3 Imaging Features;626
1.8.6.2.3.1;25.2.3.1 Liposarcoma;627
1.8.6.2.3.2;25.2.3.2 Hemangiopericytoma and Angiosarcoma;627
1.8.6.2.3.3;25.2.3.3 Malignant Fibrous Histiocytoma and Fibrosarcoma;627
1.8.6.2.3.4;25.2.3.4 Leiomyosarcoma and Rhabdomyosarcoma;627
1.8.6.2.3.5;25.2.3.5 Osteosarcoma, Chondrosarcoma, Ewing Sarcoma, and Synovial Sarcoma;628
1.8.6.2.3.6;25.2.3.6 Granulocytic Sarcomas (Chloromas);629
1.8.6.2.3.7;25.2.3.7 Kaposi Sarcoma;630
1.8.6.2.4;25.2.4 Diagnostic Approach;630
1.8.6.3;References;632
1.8.7;26: Cystic Renal Masses;634
1.8.7.1;26.1 Introduction;635
1.8.7.2;26.2 Definition and Etiology of Cystic Renal Masses;635
1.8.7.2.1;26.2.1 Definition;635
1.8.7.2.2;26.2.2 Etiologies;635
1.8.7.2.2.1;26.2.2.1 Benign Nonneoplastic Cystic Masses;635
1.8.7.2.2.2;26.2.2.2 Benign Cystic Neoplasms (Fig. 26.1);635
1.8.7.2.2.3;26.2.2.3 Malignant Cystic Neoplasms (Fig. 26.1);637
1.8.7.2.2.3.1;Multilocular Cystic RCC of Low Malignant Potential;637
1.8.7.2.2.3.2;Clear Cell or Papillary RCCs with Cystic Changes;637
1.8.7.2.2.3.3;Tubulocystic Carcinoma;637
1.8.7.3;26.3 Imaging Techniques and Key Interpretation Criteria;638
1.8.7.3.1;26.3.1 Conventional Ultrasound;638
1.8.7.3.2;26.3.2 Contrast-Enhanced Ultrasound;639
1.8.7.3.3;26.3.3 Computed Tomography;640
1.8.7.3.4;26.3.4 MR Imaging;641
1.8.7.4;26.4 The Bosniak Classification System;643
1.8.7.4.1;26.4.1 Field of Utilization;644
1.8.7.4.2;26.4.2 Bosniak Categories (Fig. 26.10; Table 26.1);644
1.8.7.4.2.1;26.4.2.1 Category I Lesions (Fig. 26.12);646
1.8.7.4.2.2;26.4.2.2 Category II Lesions (Figs. 26.13–26.15);646
1.8.7.4.2.3;26.4.2.3 Category IIF Lesions (Fig. 26.17);648
1.8.7.4.2.4;26.4.2.4 Category III Lesions (Figs. 26.18 and 26.19);650
1.8.7.4.2.5;26.4.2.5 Category IV Lesions (Figs. 26.20 and 26.21);651
1.8.7.4.3;26.4.3 Utility and Limitations of the Bosniak Classification System;652
1.8.7.5;26.5 Indeterminate Renal Masses and Misclassified Cysts;652
1.8.7.5.1;26.5.1 Very Small Renal Mass;653
1.8.7.5.2;26.5.2 Renal Mass with Indeterminate Attenuation;653
1.8.7.5.3;26.5.3 Renal Mass with Indeterminate “Enhancement”;655
1.8.7.5.4;26.5.4 Renal Cyst with Discrepant Findings Between CT and Other Modalities;657
1.8.7.6;References;658
1.9;Part V:Special Topics;661
1.9.1;27: The Pediatric Kidney;662
1.9.1.1;27.1 General Remarks on the Principles of Imaging Children and Radiation Protection Issues;663
1.9.1.2;27.2 Vesicoureteral Reflux and Reflux Nephropathy;666
1.9.1.2.1;27.2.1 General Considerations;666
1.9.1.2.2;27.2.2 Methods for Vesicoureteral Reflux Assessment;667
1.9.1.2.2.1;27.2.2.1 Ultrasound;667
1.9.1.2.2.2;27.2.2.2 Voiding Cystourethrography;670
1.9.1.2.2.3;27.2.2.3 Radionuclide Cystography (RNC);671
1.9.1.2.3;27.2.3 Imaging Algorithm – When to Perform What in Whom;671
1.9.1.3;27.3 Childhood Urinary Tract Infection, Including (Acute) Pyelonephritis;671
1.9.1.3.1;27.3.1 Which Imaging Modalities are Available and How Do Things Look Like?;672
1.9.1.3.2;27.3.2 Imaging Algorithm in Pediatric Urinary Tract Infection;675
1.9.1.4;27.4 Congenital Hydronephrosis and Urinary Tract Obstruction;676
1.9.1.4.1;27.4.1 Congenital Hydronephrosis;676
1.9.1.4.2;27.4.2 Imaging Algorithm for Congenital Hydronephrosis;676
1.9.1.4.3;27.4.3 Obstructive Uropathy;676
1.9.1.4.4;27.4.4 Imaging Algorithm in Obstructive Uropathy;678
1.9.1.5;27.5 Childhood Urolithiasis and Nephrocalcinosis (see also Chap. 15);680
1.9.1.5.1;27.5.1 Urolithiasis;680
1.9.1.5.2;27.5.2 Nephrocalcinosis;683
1.9.1.6;27.6 Pediatric Renovascular Disorders (General Renovascular Disorders) (see Chap. 18);684
1.9.1.6.1;27.6.1 Pediatric Renal Artery Stenosis;684
1.9.1.6.2;27.6.2 The Hemolytic-Uremic Syndromes;684
1.9.1.6.3;27.6.3 Renal Vein Thrombosis;685
1.9.1.6.4;27.6.4 Other Pediatric Vascular Conditions;686
1.9.1.7;27.7 Renal Neoplasms in Childhood (see also Chaps. 20–26);686
1.9.1.7.1;27.7.1 Imaging Benign Renal Tumors in Children;687
1.9.1.7.2;27.7.2 Indeterminate Renal Masses;689
1.9.1.7.3;27.7.3 Malignant Tumors;690
1.9.1.8;27.8 Other Renal Parenchymal Disease and Miscellaneous Renal Disorders;693
1.9.1.8.1;27.8.1 Pediatric Cystic Renal Disease;693
1.9.1.8.2;27.8.2 Pediatric Renal Parenchymal Disease;693
1.9.1.8.3;27.8.3 Acute and Chronic Renal Failure;694
1.9.1.8.4;27.8.4 Imaging in Childhood Renal Trauma;695
1.9.1.9;27.9 Conclusion;696
1.9.1.10;References;696
1.9.2;28: The Kidney in the Elderly;701
1.9.2.1;28.1 Morphologic Alterations in the Kidney of an Elderly Patient;703
1.9.2.2;28.2 Nephrosclerosis;704
1.9.2.3;28.3 Renovascular Disease;707
1.9.2.4;28.4 Renal Infarction;711
1.9.2.5;28.5 Atheroembolic Renal Disease;712
1.9.2.6;28.6 Renal Vein Thrombosis;715
1.9.2.7;28.7 Renal Failure;716
1.9.2.7.1;28.7.1 Acute Renal Failure;716
1.9.2.7.2;28.7.2 Chronic Renal Failure;717
1.9.2.8;28.8 Obstructive Uropathy;720
1.9.2.9;28.9 Renal Infections;720
1.9.2.10;28.10 Neoplastic Pathologies;724
1.9.2.11;References;729
1.9.3;29: Renal Failure;731
1.9.3.1;29.1 Acute Renal Failure;732
1.9.3.1.1;29.1.1 Prerenal and Renal Acute Renal Failure;733
1.9.3.1.2;29.1.2 Postrenal Acute Renal Failure;736
1.9.3.1.3;29.1.3 Clinical Scenarios Related to ARF;738
1.9.3.2;29.2 Chronic Renal Failure;741
1.9.3.2.1;29.2.1 Classification;741
1.9.3.2.2;29.2.2 Clinical Scenarios Related to Chronic Renal Failure;742
1.9.3.3;References;746
1.9.4;30: Renal Transplantation;748
1.9.4.1;30.1 Epidemiology;748
1.9.4.2;30.2 Presurgical Evaluations;749
1.9.4.2.1;30.2.1 Evaluation of the Graft Recipient;749
1.9.4.2.1.1;30.2.1.1 The Lower Urinary Tract;749
1.9.4.2.1.2;30.2.1.2 Status of the Vasculature;749
1.9.4.2.2;30.2.2 Evaluation of the Donor;749
1.9.4.2.2.1;30.2.2.1 Evaluation of Cadaveric Donor Kidneys;749
1.9.4.2.2.2;30.2.2.2 Evaluations of Living-Donor Kidneys;750
1.9.4.3;30.3 Current Surgical Techniques;750
1.9.4.3.1;30.3.1 Graft Preservation;750
1.9.4.3.2;30.3.2 Transplantation;750
1.9.4.4;30.4 Radiological Assessment of the Graft;750
1.9.4.5;30.5 Early Graft Complications (First Year);754
1.9.4.5.1;30.5.1 Urological Complications;754
1.9.4.5.1.1;30.5.1.1 Urinary Fistulas;754
1.9.4.5.1.2;30.5.1.2 Ureteral Stenosis;756
1.9.4.5.1.3;30.5.1.3 Graft Infection;756
1.9.4.5.1.4;30.5.1.4 Perigraft Fluid Collections;756
1.9.4.5.2;30.5.2 Vascular Complications;760
1.9.4.5.2.1;30.5.2.1 Renal Artery Thrombosis;760
1.9.4.5.2.2;30.5.2.2 Infarctions;762
1.9.4.5.2.3;30.5.2.3 Renal Artery Stenosis;762
1.9.4.5.2.4;30.5.2.4 Renal Vein Thrombosis;764
1.9.4.5.2.5;30.5.2.5 Vascular Complications of Biopsy;765
1.9.4.5.2.6;30.5.2.6 Parenchymal Necrosis;765
1.9.4.5.3;30.5.3 Medical Complications;766
1.9.4.5.3.1;30.5.3.1 Clinical Considerations;766
1.9.4.5.3.2;30.5.3.2 Imaging;770
1.9.4.6;30.6 Long-Term Follow-Up;771
1.9.4.6.1;30.6.1 Chronic Allograft Nephropathy (CAN);771
1.9.4.6.2;30.6.2 Recurrence of the Initial Nephropathy;771
1.9.4.6.3;30.6.3 Calculus Disease;772
1.9.4.6.4;30.6.4 Solid Tumors;772
1.9.4.6.5;30.6.5 Lymphoproliferative Disorders/PTLD;772
1.9.4.7;30.7 Conclusion;773
1.9.4.8;References;774
1.9.5;31: Imaging of Dialysis;777
1.9.5.1;31.1 Uremic Syndrome;778
1.9.5.1.1;31.1.1 Electrolyte Alterations;778
1.9.5.1.2;31.1.2 Extrarenal Disorders;779
1.9.5.2;31.2 Acquired (Dialysis-Associated) Cystic Kidney Disease;781
1.9.5.3;31.3 Dialysis Access Complications;787
1.9.5.3.1;31.3.1 Arteriovenous Fistulas;788
1.9.5.3.2;31.3.2 Arteriovenous Grafts;789
1.9.5.3.3;31.3.3 Dialysis Access Catheters;790
1.9.5.4;References;792
1.9.6;32: Imaging of the Postoperative Kidney;794
1.9.6.1;32.1 Management of Renal Masses;794
1.9.6.2;32.2 Renal Surgery;796
1.9.6.2.1;32.2.1 Radical Nephrectomy;796
1.9.6.2.2;32.2.2 Partial Nephrectomy: Nephron-Sparing Surgery;797
1.9.6.3;32.3 Complications After Renal Surgery;801
1.9.6.3.1;32.3.1 Complications After Radical Nephrectomy;801
1.9.6.3.2;32.3.2 Complications After Partial Nephrectomy;802
1.9.6.4;32.4 Tumoral Recurrence and Distant Metastases;806
1.9.6.4.1;32.4.1 Tumoral Recurrence After Radical Nephrectomy;807
1.9.6.4.2;32.4.2 Tumoral Recurrence After Partial Nephrectomy;807
1.9.6.4.3;32.4.3 Distant Metastases;808
1.9.6.5;References;811
1.9.7;33: Contrast Media-Induced Nephropathy and Nephrogenic Systemic Fibrosis;813
1.9.7.1;33.1 Introduction;814
1.9.7.2;33.2 Contrast Media-Induced Nephropathy;814
1.9.7.2.1;33.2.1 Definition;814
1.9.7.2.2;33.2.2 Incidence;814
1.9.7.2.3;33.2.3 Clinical Features;815
1.9.7.2.4;33.2.4 Risk Factors;815
1.9.7.2.4.1;33.2.4.1 Patient-Related Risk Factors;815
1.9.7.2.4.2;33.2.4.2 Procedure-Related Risk Factors;816
1.9.7.2.4.3;33.2.4.3 Coexistence of Multiple Risk Factors;817
1.9.7.2.5;33.2.5 Strategies for Risk Reduction;817
1.9.7.2.5.1;33.2.5.1 Hydration Protocols;817
1.9.7.2.5.2;33.2.5.2 Pharmacologic Agents and Withdrawal of Nephrotoxic Drugs;818
1.9.7.2.5.3;33.2.5.3 Hemodialysis and Hemofiltration;818
1.9.7.2.5.4;33.2.5.4 Choice of Contrast Material Type and Dose;818
1.9.7.2.6;33.2.6 Open Questions;818
1.9.7.2.7;33.2.7 Guideline;819
1.9.7.3;33.3 Nephrogenic Systemic Fibrosis;819
1.9.7.3.1;33.3.1 Definition;819
1.9.7.3.2;33.3.2 Clinical Features;819
1.9.7.3.3;33.3.3 Risk Factors;819
1.9.7.3.4;33.3.4 The Role of Contrast Material;820
1.9.7.3.5;33.3.5 Diagnosis;821
1.9.7.3.6;33.3.6 Therapy;823
1.9.7.3.7;33.3.7 Guideline;823
1.9.7.4;33.4 Conclusion;824
1.9.7.5;References;824
1.9.8;34: Functional Imaging of the Kidney;827
1.9.8.1;34.1 Contrast Agents and Technical Issues;828
1.9.8.1.1;34.1.1 Sonography;828
1.9.8.1.2;34.1.2 CT;828
1.9.8.1.3;34.1.3 MR Imaging;829
1.9.8.2;34.2 Measurement of Glomerular Filtration;829
1.9.8.2.1;34.2.1 Measurement of Split Renal Function;830
1.9.8.2.2;34.2.2 MR Quantification of Global GFR;830
1.9.8.2.3;34.2.3 MR Quantification of Single Kidney GFR (SKGFR);831
1.9.8.2.3.1;34.2.3.1 Monitoring of Tracer Intrarenal Kinetics;831
1.9.8.2.3.1.1;MR Technical Requirements;832
1.9.8.2.3.1.2;Postprocessing;833
1.9.8.2.3.1.3;Compartment Models;834
1.9.8.2.3.1.4;Accuracy and Reproducibility;834
1.9.8.2.3.2;34.2.3.2 Single Kidney Extraction Fraction;834
1.9.8.3;34.3 Renal Flow Rate and Renal Perfusion;836
1.9.8.3.1;34.3.1 Renal Flow Rate;837
1.9.8.3.2;34.3.2 Renal Perfusion;837
1.9.8.3.2.1;34.3.2.1 Ultrasound;837
1.9.8.3.2.2;34.3.2.2 MRI;837
1.9.8.3.2.2.1;Dynamic MR Imaging;838
1.9.8.3.2.2.2;Renal Perfusion Using Spin-Labeling;840
1.9.8.4;34.4 Tubular Function;841
1.9.8.4.1;34.4.1 Intratubular Concentration of Diffusible Gd-Chelate;841
1.9.8.4.2;34.4.2 Intratubular Transit of Macromolecular Gd-Chelate (T1 Effect);841
1.9.8.5;34.5 Urinary Excretion and Renal Transit Time;844
1.9.8.6;34.6 Angiotensin Converting Enzyme (ACE) Inhibitor-Sensitized MR Renography;844
1.9.8.7;34.7 Intrarenal Oxygenation;845
1.9.8.8;34.8 Renal Diffusion;846
1.9.8.9;References;848
1.9.9;35: Molecular Imaging and Tumoural Antigen Targeting;852
1.9.9.1;35.1 Pre-Clinical Molecular Imaging;852
1.9.9.1.1;35.1.1 Basic Principles of Nuclear Medicine Techniques;853
1.9.9.1.1.1;35.1.1.1 Small Animal PET (SA-PET);853
1.9.9.1.1.2;35.1.1.2 Small Animal SPECT (SA-SPECT);854
1.9.9.1.2;35.1.2 Basic Principles of Other Molecular Imaging Techniques;855
1.9.9.1.2.1;35.1.2.1 Small Animal Magnetic Resonance Imaging (SA-MRI);855
1.9.9.1.2.2;35.1.2.2 Optical Imaging;855
1.9.9.2;35.2 The Kidney: Molecular Imaging and Tumoural Antigen Targeting;856
1.9.9.2.1;35.2.1 SA-PET Imaging Methods to Analyse the Renal Function;856
1.9.9.2.2;35.2.2 SA-PET for the In Vivo Evaluation of Renal Cell Carcinoma in Animal Models;856
1.9.9.2.3;35.2.3 SA-MRI for the In Vivo Tracking of Stem Cells in Animal Models of Renal Impairment;857
1.9.9.3;References;859
1.9.10;36: Research Perspectives and Future Trends in Renal Imaging;860
1.9.10.1;36.1 MR Imaging of Cell Targeting;861
1.9.10.1.1;36.1.1 Intrarenal Macrophage Activity;861
1.9.10.1.2;36.1.2 Principles of MR Targeting of Macrophages;861
1.9.10.1.3;36.1.3 Macrophage Targeting in Experimental Models;862
1.9.10.1.4;36.1.4 Macrophage Targeting in Humans;864
1.9.10.2;36.2 MR Imaging of Stem Cell Tracking;865
1.9.10.3;36.3 MR Imaging and Monitoring of Gene Therapy;868
1.9.10.4;36.4 Imaging of Cell Receptors;868
1.9.10.5;36.5 MR Imaging of Enzyme Synthesis or Activity;869
1.9.10.5.1;36.5.1 MR Imaging of Matrix Metalloproteases (MMPs);869
1.9.10.5.2;36.5.2 MR Imaging of Myeloperoxidase (MPO);869
1.9.10.6;36.6 New Parameters of Renal Function;870
1.9.10.6.1;36.6.1 Imaging of Tubule Dysfunction;870
1.9.10.6.2;36.6.2 Renal pH MR Imaging;870
1.9.10.6.3;36.6.3 Renal Sodium Imaging;870
1.9.10.6.4;36.6.4 MR Imaging of Proteinuria;871
1.9.10.7;36.7 Imaging of Intrarenal Fibrosis;871
1.9.10.8;36.8 Conclusion;874
1.9.10.9;References;875
1.10;Index;878