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Imaging of the upper
urinary tract (Part 1).
Dr/ ABD ALLAH NAZEER. MD.
Renal infection.
streaky contrast staining in the area of inflammation, typical
of pyelonephritis with striated nephrogram (black arrow).
Acute pyelonephritis of the right and left kidney with striated nephrogram.
Pyohydronephrosis.
Pyohydronephrosis.
Emphysematous pyelonephritis.
Emphysematous pyelonephritis.
Xanthogranulomatous pyelonephritis in
a 80-year-old woman with chronic pyuria.
CT is the most sensitive modality for visualizing renal
calcifications and CT IVP is more sensitive at
identifying all manifestations of renal tuberculosis .
Early papillary necrosis (single or multiple) resulting
in uneven caliectasis progressive multifocal strictures
can affect any part of the collecting system
generalized or focal hydronephrosis mural thickening
and enhancement poorly enhancing renal
parenchyma, either due to direct involvement or due
to hydronephrosis
end stage progressive hydronephrosis results in very
thin parenchyma, mimicking multiple thin walled
cysts amorphous dystrophic calcification eventually
involves the entire kidney (known as putty kidney).
Tuberculous autonephrectomy.
Renal cystic and solid masses.
Kidney - Cystic masses.
Renal cysts can be classified according to the Bosniak
classification depending on their features.
Type I cysts are simple cysts.
Type II are the minimally complicated cysts.
Type I and II can be ignored.
Type II F are probably benign, but need to be followed.
Type III and IV both are surgical lesions.
Type IV is inevitably malignant and in the type III group about
80-90% turn out to be malignant as well.
Axial and coronal
reformatted CT
images of simple
renal cyst (Bosniak
category 1 cyst.
LEFT: thin, smooth septation.....Ignore
RIGHT: thick enhancing septation ... Excise
Bosniak Type 111.
Bosniak Type 1V.
Multilocular cystic nephroma.
Oncocytoma of right kidney. Triphasic study.
Renal oncocytoma.
Renal angiomyolipoma.
Renal cell carcinoma with CT angiography.
Renal mass with invasion of the renal vein and IVC.
Renal cell
carcinoma.
Transitional cell carcinoma of the renal pelvis.
Transitional cell carcinoma of the renal pelvis is
uncommon compared to renal cell carcinoma, and can be
challenging to identify on routine imaging when small.
Transitional cell carcinomas account for 85 % of all uroepithelial
tumors of the renal pelvis (the remaining 5 % being made up of
squamous cell carcinoma (the majority) and adenocarcinoma
(rare)1. They have one of two main morphologic patterns:
papillary
account for >85% tumors 1
multiple frondlike papillary projections
tend to be low grade and invasion beyond the mucosa is a
late feature
non-papillary
sessile or nodular tumors
tend to be high grade with early invasion beyond mucosa.
Cases of renal transitional cell carcinoma.
Renal transitional cell carcinoma.
Renal transitional cell carcinoma.
Transitional cell carcinoma.
Bilateral renal lymphoma with splenic involvement.
<body
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Renal metastasis
Thank You.

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