Methods of Examination l Contrast Medium 1 Chemistry 1 Pharmacokinetics 1 Side Effects 6 Intravenous Urography 6 Standard Radiographic 7 Specialized 7 Retrograde Urography 11 Retrograde Ureteropyelography 11 Retrograde 13 Retrograde Urethrography under Fluoroscopic Control 13 Computed 14 Preparation 15 Scans 15 15 Preparation • • 16 Technique ' 16 Sonography 18 Preparation 18 Examination Technique 18 Methods 18 Radioisotope Renography 20 Renal Scanning 20 Perfusion . 20 Radionuclide 22

Radiologic Signs 23 Urographic Signs 23 Normal Urogram 23 Kidneys 23 Pericaliceal System 25 The 27 The Bladder 28 The 31 Position Anomalies 34 Congenital Positional Abnormalities 34 Acquired Positional Abnormalities 35

http://d-nb.info/871001535 Kidney Enlargement . 38 Unilateral Kidney Enlargement 38 Bilateral Kidney Enlargement 39 Small Kidney 40 Unilateral Decrease in Kidney Size 40 Bilateral Small Kidney 41 Unilateral Functional Impairment 42 Absent Kidney, Apparent Functional Impairment 42 Prerenal Etiologies 42 Intrarenal Etiologies 43 Postrenal Etiologies 44 Bilateral Functional Impairment 44 Pre- or Intrarenal Etiologies 45 Postrenal Etiologies 45 Renal Space-Occupying Process 46 Solitary Space-Occupying Processes 47 Multiple Space-Occupying Processes 51 Cortex Notching 52 Intrarenal Contrast Medium Depot 54 Contrast Medium-Filled Cavities 54 Striated Contrast Medium Embedments 54 Intrarenal Gas Accumulation 57 Intrarenal Calcifications 58 Extrarenal Calcifications 62 Extrarenal Opacities in Mesogastrium and Epigastrium 62 Calcification in Pelvic Cavity Outside the Urinary Tract or Opacities 66 Displacement and Compression of the Pericaliceal System .... 70 Dilation of the Pericaliceal System 71 Filling Defects in the Pericaliceal System 74 Artefacts 74 Displacement and Compression of the 78 Displacement of the Abdominal Ureter 78 Displacement of the Ureter 79 Dilation of the Ureters 80 Filling Defects and Strictures of the Ureters 81 Filling Defects 81 Strictures and Impressions 81 Fistulas of the Ureters 82 Calcification of the Ureter 83 Deformity of the 83 Volume Changes 83 Irregularities of the Contour 85 Displacement 85 Filling Defects of the Urinary Bladder 89 Intravesical Processes 90 Vesical Wall Processes 90 Extravesical Processes 92 Fistulas of the Urinary Bladder 92 Congenital Fistula 92 Traumatic Fistula 93 Neoplastic Fistula 94 Inflammatory Fistula 94 Stenosis of the Urethra 94 Paraurethral Contrast Medium Disposition 96 Filling Defects of the Urethra 96 Displacement of the Urethra 96

Computed Tomography Signs 97 Normal Computed Tomogram 97 Pathologic Computed Tomography 100 Peri- and Pararenal Lesions 100 Intraparenchymatous Processes 100 Renal Sinus Processes 102

Angiographic Signs 104 Normal Angiogram 104 Renal Arteries 104 Renal 104 Arteries of the Renal Capsule 107 Ureteral Vessels 107 Vessels of the Urinary Bladder 108 Displacement of the Vessels 109 Narrowing of Vessels 110 Generalized Narrowing of the Arteries 110 Localized Constriction of the Arteries 110 Localized Constriction of the Veins Ill Dilation of Vessels Ill Hypovascularized Regions 113 Solitary Areas 113 Multiple Areas 114 Hypervascularized Regions 114 Pathologic Vascular Pattern 115 Tumors 115 Inflammations 118 Dilation and Displacement of the Collaterals 118 Dilation 118 Displacement 119 Sonographic Signs 119 Normal Sonogram 119 Pathologic Sonogram 122 Peri- and Pararenal Processes 122 Intraparenchymatous Processes 123 Processes in the Renal Sinus 124 Nuclear Medicine Signs 126 Normal Findings in Nuclear Medicine 126 Radiovenogram 126 Sequential Scintigraphy 126 Clearance 126 Pathologic Nuclear Medicine Findings 128 Radiorenogram 128 Scintigraphy 128

Diseases of the Urinary Tract 131 Malformations of the Urinary Tract 131 Malformations of the Kidneys 131 Malformations of the Pericaliceal System and of the Ureter .... 135 Malformations of the Bladder 139 Malformations of the Urethra 141 Vasopathy 142 Nephrosclerosis 142 Senile Nephrosclerosis 143 Benign Nephrosclerosis 143 Malignant Nephrosclerosis 143 144 Papillary Necrosis 147 Rare Vascular Diseases of the Kidney 148 Cysts 151 Simple Renal Cysts 151 Cystic Kidney, Adult Type (Bilateral Polycystic Renal Degeneration) 154 Medullary Sponge Kidney 157 Pyelogenic Cysts (Calix Diverticuli) 157 Rare Cystic Renal Diseases 158 Cystic Kidney, Infantile Type 158 Multicystic Renal Dysplasia (Unilateral Renal Dysplasia) .... 158 Multilocular Cysts (Benign Multilocular, Unilateral Cystic Nephroma) 160 Uremic Medullary Cystic Kidney (Juvenile Nephronophthisis) 160 Pararenal Pseudocysts (Urinoma, Renal Hydrocele, Pseudohydronephrosis) 160 Neoplasms 162 Benign Renal Tumors 162 Hypernephroma 163 Wilms' Tumor 167 Tumors of the Renal Pelvis and Ureters 169 Neoplasms of the Urinary Bladder 170 Rare Tumors of the Urinary Tract 172 Infections 173 Acute Pyelonephritis 173 Chronic Pyelonephritis 176 Intra- and Perirenal Abscesses 179 Pyonephrosis 181 Urogenital Tuberculosis 182 Abacterial Nephritides and Nephrosis 185 Urocystitis 186 Rare Inflammations (Rare Pathogens) of the Urinary Tract .... 186 Rare Inflammations (Rare Reaction Pattern) of the Urinary Tract 189 Urolithiasis 191 Radiologic Criteria for Lithiasis Therapy 194 Obstructive Uropathy 197 Mechanical Obstruction 201 Vesicoureteral Reflux 205 Primary Vesicoureteral Reflux 205 Secondary Vesicoureteral Reflux 205 Neurogenic Bladder 206 Spastic Bladder 208 Atonic Bladder 208 Spastic-Atonic Mixed Form 208 Trauma 210 Renal Trauma 210 Late Sequelae of Renal Trauma 214 Ureter Injuries 215 Urinary Bladder Injuries 216 Urethral Lesions 217 References 218 Index 227