Röntgendiagnostik Des Urogenitalsystems / Roentgen Diagnosis of the Urogenital System

ISBN-13: 9783642952517 / Angielski / Miękka / 2012 / 668 str.

Olle Olsson

Opis

In 1962 in the series Handbuch der Urologie - Encyclopedia of Urology - Ency- clopedie d'Urologie the roentgen examination of the kidney and ureter was extensively presented by the present author in collaboration with Gosta Jonsson. The roentgen exa- mination of the distal genital tract and the male genital organs was presented by Lind- blom and Romanus. In the corresponding series Handbuch der Medizinischen Radiologie - Encyclopedia of Medical Radiology ten years later, we have arrived at the publication of the roentgeno- logy of the kidney and the urinary tract. It was felt expedient that the entire chapter on urologic roentgenology be revised by the present author on the basis of a greatly enlarged current material from the Department of Diagnostic Radiology, University Hospital, Lund, Sweden. This hospital is a regional university hospital for a population of approxi- mately 1,200,000 inhabitants in southern Sweden. Patients with specific problems for qualified diagnostic and therapeutic procedures are referred to Lund from other hospitals within the region, both central and local hospitals, and consulting cases are sent from very wide distances.

Spis treści

— Contents.- I: Roentgen diagnosis of the kidney and the ureter.- A. Introduction.- B. Examination fundamentals.- I. Equipment.- II. Radiation protection.- III. Preparation of the patient for roentgen examination.- C. Examination methods.- I. Plain radiography.- 1. Position of kidneys.- 2. Shape of kidneys.- 3. Size of kidneys.- 4. Calcifications projected onto the urinary tract.- II. Additional methods.- 1. Zonography and tomography.- 2. Retroperitoneal pneumography.- 3. Roentgen examination of the surgically exposed kidney.- III. Pyelography and urography.- 1. Pyelography.- a) Contrast media.- b) Method.- c) Roentgen anatomy.- d) Antegrade pyelography.- e) Contraindications.- 2. Urography.- a) Contrast media.- b) Excretion of contrast medium during urography.- c) Injection and dose of contrast medium.- d) Urography in renal insufficiency.- e) Urography in patients with myeloma.- f) Reactions.- g) Examination technique.- h) Urography at health-check examinations.- IV. Renal angiography.- 1. Aortic puncture.- 2. Catheterization.- 3. Comparison between selective and aortic renal angiography.- 4. Angiography of operatively exposed kidney.- 5. Injection of contrast medium.- 6. Contrast media.- 7. Risks.- 8. Anatomy and roentgen anatomy.- a) Arteries.- b) Nephrographic phase.- c) Venous phase.- d) Flow studies during angiography.- V. Renal phlebography.- D. Anomalies.- I. Anomalies of the renal pelvis and associated anomalies of the ureter.- 1. Double renal pelvis.- 2. Blind ureter.- 3. Anomalies of the calyces.- 4. Anomalies in the border between calyces and renal parenchyma.- II. Anomalies of the renal parenchyma.- 1. Aplasia and agenesia.- 2. Hypoplasia.- a) General hypoplasia.- b) Local hypoplasia.- III. Malrotation.- IV. Ectopia.- V. Fusion.- VI. Vascular changes in renal anomalies.- Multiple renal arteries.- a) Anatomic investigations.- b) Angiographic studies.- c) Level of origin.- VII. Renal angiography in anomalies.- VIII. Ureteric anomalies.- 1. Retro-caval ureter.- 2. Ureters with ectopic orifice.- 3. Ureteric valve.- E. Nephro- and ureterolithiasis.- I. Chemical composition of stones.- II. Age, sex, and side involved.- III. Size and shape of stones.- IV. Stone in association with certain diseases.- V. Stones induced by side-effects of therapy.- VI. Formation of stones from a roentgenologic point of view.- VII. Plain roentgenography.- 1. Differential diagnosis of stone by plain roentgenography.- 2. Disappearance of renal and ureteric stones.- 3. Perforation.- VIII. Roentgen examination in association with operation.- IX. Urography and pyelography.- X. Nephrectomy, partial nephrectomy, and uretero-lithotomy.- XI. Roentgen examination during renal colic.- 1. Plain radiography.- 2. Urography.- 3. Discussion of signs of stasis.- 4. Backflow in acute renal colic.- 5. Reflex anuria.- 6. Cessation of pain.- 7. Passage of stone.- 8. Stasis in relation to pain.- 9. Master rules in acute renal colic.- 10. Backflow in connection with stone.- XII. Renal angiography.- XIII. Nephrocalcinosis.- 1. Hyperparathyroidism.- 2. Sarcoidosis.- 3. Hypercalcemia.- 4. Glomerulonephritis, pyelonephritis, and tubular nephritis.- F. Renal, pelvic, and ureteric tumors.- I. Renal tumors.- 1. Renal carcinoma.- a) Plain roentgenography.- b) Urography, pyelography.- c) Renal angiography.- d) Phlebography.- e) Nephrotomography.- f) The growth of renal carcinoma.- g) Multiple tumors.- 2. Malignant renal tumors in children.- a) Plain roentgenography.- b) Urography and pyelography.- 3. Other types of malignant tumor.- 4. Metastases from renal carcinoma.- 5. Benign renal tumors.- 6. Roentgenologic differential diagnosis in expansive lesions.- 7. General views on diagnostic difficulties in renal tumor.- 8. Short summary of tumor diagnosis and differential diagnosis.- a) Plain roentgenography.- b) Pyelography and urography.- c) Puncture.- d) Renal angiography.- e) Metastases.- II. Tumors of the renal pelvis and the ureter.- 1. Tumors of the renal pelvis.- 2. Tumors of the ureter.- G. Renal cysts and polycystic disease.- I. Serous cysts.- 1. Simple cysts.- a) Plain radiography.- b) Urography and pyelography.- c) Renal angiography.- d) Puncture of cyst.- e) Flow studies.- 2. Peripelvic lymphatic cysts.- 3. Multilocular cysts.- II. Hydatid cysts.- III. Polycystic disease.- a) Plain radiography.- b) Urography and pyelography.- c) Renal angiography.- H. Renal tuberculosis.- I. Remarks on pathology.- II. Roentgen examination.- 1. Plain roentgenography.- 2. Urography and pyelography.- a) Ureteric changes.- b) Excretion of contrast medium during urography.- c) Renal angiography.- 3. Differential diagnosis.- 4. Follow-up examinations.- III. General observations on examination methods in renal tuberculosis.- I. Primary vascular lesions.- I. Arteriosclerosis, fibroplasia, and other types of arterial disease.- II. Arterial aneurysms.- Plain radiography, urography, and angiography.- III. Arteriovenous anastomoses and fistulae.- IV. Emboli and thrombosis in the renal artery.- V. Thrombosis of the renal vein.- Varices.- VI. Roentgen-diagnostics in renal hypertension.- VII. Roentgen examination in hematuria.- J. Injury to the kidney and ureter.- I. Classification of renal ruptures.- II. Plain radiography.- III. Urography and pyelography.- IV. Renal angiography.- V. Healing of renal ruptures.- VI. Choice of therapy.- VII. Perirenal hematoma.- K. Dilatation of the urinary tract.- I. The obstructed pelviureteric junction.- 1. Plain radiography.- 2. Pyelography and urography.- 3. Penal angiography.- 4. Check roentgenography after operation for hydronephrosis.- 5. Vessels and hydronephrosis.- II. Dilatation of varying origin.- 1. Dilatation of the urinary tract in infants.- 2. Dilatation in prostatic hyperplasia.- a) Plain radiography.- b) Urography.- 3. Dilatation of the urinary tract during pregnancy.- 4. Ureteric dilatation following pregnancy.- 5. Ureteric dilatation following use of oral contraceptives.- 6. Local dilatation of the urinary tract.- 7. Megaureter.- 8. Dilatation of the urinary tract in double renal pelvis.- L. Generalized diseases of the renal parenchyma.- I. Acute renal insufficiency.- 1. General considerations.- 2. Edema.- 3. Estimation of the size of the kidneys.- a) Enlarged kidneys.- b) Kidneys smaller than normal.- 4. Glomerulonephritis.- 5. Tubular nephritis.- 6. Gross bilateral cortical necrosis.- 7. Pyelonephritis.- a) Plain roentgenography.- b) Urography.- c) Renal angiography.- d) Pyelonephritis and the lower urinary tract.- 8. Papillary necrosis.- a) Plain radiography.- b) Urography and pyelography.- c) Renal angiography.- 9. Fibrolipomatosis of the kidney.- 10. Radiation nephritis.- 11. Renal hyperplasia.- 12. Mycosis.- II. Problems in connection with hemodialysis.- M. Perinephritis, renal abscess, and carbuncle.- I. Role of roentgen examination.- II. Roentgen findings.- 1. Plain radiography.- 2. Examination with contrast medium.- 3. Indirect roentgen findings.- III. Carbuncle and abscess of the kidney.- Examination with contrast medium.- N. Gas in the urinary tract and fistula formation.- Development of gas in the urinary tract.- O. Medullary sponge kidney (benign renal tubular ectasia).- 1. Plain radiography.- 2. Urography.- P. The backflow phenomenon.- I. Tubular backflow.- II. Reflux to blood-stream. Pyelovenous backflow.- III. Reflux to sinus.- IV. Pyelolymphatic backflow.- V. Relation of reflux to bloodstream.- VI. Frequency of reflux.- VII. Backflow in acute renal colic.- VIII. Significance of reflux from a roentgen-diagnostic point of view.- IX. Risks associated with reflux.- Q. Renal transplantation.- R. Miscellaneous changes particularly of the ureter.- I. Ureterocele.- II. Ureteric prolapse.- III. Ureteric endometriosis.- IV. Herniation of the ureter.- V. Ureteric diverticula.- VI. Ureteric involvement by aortic aneurysm and other pathologic processes.- VII. Regional ureteritis.- VIII. Peri-ureteritis obliterans, retroperitoneal fibrosis.- IX. Bilharziosis.- X. Amyloidosis.- XI. Leukoplakia.- XII. Pyeloureteritis cystica.- XIII. Ureteric stump after nephrectomy.- XIV. Ureteric fistulae.- II: Roentgen diagnosis of the distal part of the urinary tract.- A. Introduction.- B. Examination methods.- I. Plain radiography.- II. Urethrocystography.- Technique of examination.- a) Instrumentation.- b) Contrast medium.- c) Roentgen anatomy of the bladder.- d) Roentgen anatomy of the urethra.- e) Performance of the examination.- f) Supplementary methods.- 1. Double contrast cystography.- 2. Perivesical pneumography.- g) Urethrocystography in children.- h) Complications.- III. Angiography of the bladder.- 1. Roentgen anatomy of the arterial supply of the bladder.- 2. Technique.- C. Pathologic changes of the bladder, prostate and urethra.- I. The Bladder.- 1. Anomalies.- a) Ectopia or extrophia vesicae.- b) Megalo bladder.- c) Malposition.- 2. Displacement of the bladder.- 3. Infection.- 4. Tumors.- 5. Trauma.- 6. The bladder in urinary obstruction.- 7. Stone.- 8. The neurogenic bladder.- 9. Enuresis.- 10. Bladder fistulae.- II. The Prostate.- 1. Hyperplasia of the prostatic gland.- 2. Changes post-prostatectomiam.- 3. Carcinoma.- 4. Inflammatory lesions.- 5. Contraction of the bladder neck.- III. The Urethra.- 1. Anomalies.- a) Hypospadia.- b) Epispadia.- c) Double urethra.- d) Diverticula.- e) Urethral valves.- 2. Inflammatory lesions.- 3. Strictures.- 4. Trauma.- 5. Urethral tumor.- 6. Stone and foreign bodies.- IV. Cystoureteric Reflux.- References.- Author Index.