Diagnostic Radiology

Roentgen examination of the kidney and the ureter.- Preface.- A. Introduction.- B. Equipment.- C. Radiation protection.- D. Preparation of the patient for roentgen examination.- E. 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. 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) Reactions.- e) Examination technique.- IV. Renal angiography.- a) Aortic puncture.- b) Catheterization.- c) Comparison between selective and aortic renal angiography.- d) Angiography of operatively exposed kidney.- e) Injection of contrast medium.- f) Contrast media.- g) Risks.- h) Anatomy and roentgen anatomy.- ?) Arteries.- ?) Nephrographic phase.- ?) Venous phase.- Renal phlebography.- Normal anatomy.- F. 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.- Renal angiography.- 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.- G. 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 ureterolithotomy.- XL Roentgen examination during renal colic.- 1. Plain radiography.- 2. Urography.- 3. Discussion of signs of stasis.- 4. Reflex anuria.- 5. Cessation of pain.- 6. Passage of stone.- XII. Obstructed ureteric flow and kidney function.- XIII. Renal angiography.- XIV. Nephrocalcinosis.- 1. Hyperparathyroidism.- 2. Sarcoidosis.- 3. Hypercalcaemia.- 4. Glomerulonephritis, pyelonephritis, and tubular nephritis.- H. Renal tuberculosis.- I. Remarks on pathology.- II. Roentgen examination.- 1. Plain roentgenography.- 2. Pyelography and urography.- a) Ureteric changes.- b) Excretion of contrast medium during urography.- c) Renal angiography.- 3. Differential diagnosis.- 4. Follow-up examinations.- III. General considerations on examination methods in renal tuberculosis.- J. Renal, pelvic and ureteric tumours.- I. Kidney tumours.- 1. Renal carcinoma.- a) Plain roentgenography.- b) Urography and pyelography.- c) Incidence of renal pelvic deformity.- d) Renal angiography.- e) Phlebography.- f) The growth of renal carcinoma.- g) Multiple tumours.- 2. Malignant renal tumours in children.- a) Plain roentgenography.- b) Urography and pyelography.- c) Renal angiography.- 3. Benign renal tumours.- 4. Differential diagnosis of a space-occupying renal lesion.- a) Plain roentgenography.- b) Pyelography and urography.- c) Puncture.- d) Renal angiography.- e) Metastasis.- II. Tumours of the renal pelvis and the ureter.- 1. Tumours of the renal pelvis.- Urography and pyelography.- 2. Tumours of the ureter.- K. Renal cysts.- Serous cysts.- 1. The simple cyst.- a) Plain radiography.- b) Urography and pyelography.- c) Renal angiography.- d) Puncture of cyst.- 2. Peripelvic lymphatic cysts.- 3. Multilocular cysts.- 4. Hydatid cysts.- L. Polycystic disease.- a) Plain radiography.- b) Urography and pyelography.- c) Renal angiography.- M. Primary vascular lesions.- I. Arteriosclerosis.- II. Arterial aneurysms.- Plain radiography, urography and angiography.- III. Arteriovenous anastomoses and aneurysms.- IV. Emboli in the renal artery.- V. Thrombosis of the renal vein.- N. Dilatation of the urinary tract.- I. The obstructed pelviureteric junction.- 1. Plain radiography.- 2. Pyelography and urography.- a) Pyelography.- b) Urography.- c) Renal angiography.- d) Check roentgenography after operation for hydronephrosis.- 3. Vessels and hydronephrosis.- II. Dilatation of varying origin.- 1. Dilatation of the urinary tract in infants.- 2. Dilatation in prostatic hypertrophy.- a) Plain radiography.- b) Urography.- 3. Dilatation of the urinary tract during pregnancy.- 4. Local dilatation of the urinary tract.- 5. Dilatation of the urinary tract in double renal pelvis.- O. Backflow.- 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. Significance of reflux from a roentgen-diagnostic point of view.- VIII. Risks associated with reflux.- P. Injury to kidney and ureter.- I. Classification of renal ruptures.- II. Plain radiography.- III. Urography and pyelography.- IV. Perirenal haematoma.- Q. Perinephritis, abscess and carbuncle of the kidney.- I. Rôle 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.- R. Gas in the urinary tract.- Development of gas in the urinary tract.- S. Papillary necrosis.- 1. Plain radiography.- 2. Urography and pyelography.- 3. Renal angiography.- T. Medullary sponge kidney.- 1. Roentgen diagnosis. Plain radiography.- 2. Urography.- U. 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.- 8. Replacement lipomatosis.- 9. Compensatory renal hypertrophy.- V. Miscellaneous changes particularly of ureter.- a) Ureterocele.- b) Ureteric prolapse.- c) Ureteric endometriosis.- d) Herniation of the ureter.- e) Ureteric involvement by aortic aneurysm.- g) Regional ureteritis.- h) Peri-ureteritis obliterans.- i) Bilharziosis.- k) Amyloidosis.- j) Leukoplakia.- m) Pyeloureteritis cystica.- n) Ureteric stump after nephrectomy.- References.- Roentgen examination of the distal urinary tract and of the male genital organs.- I. General indications for roentgenologic examination of the distal urinary tract and its value in relation to that of endoscopy.- II. Complications of roentgenologic examination and its contraindications.- III. Urethrocystographic technique: instruments, contrast medium, procedure.- IV. The urinary bladder.- 1. Normal and pathologic roentgenologic features.- 2. Developmental anomalies.- 3. Positional changes.- 4. Traumatic changes.- 5. Inflammatory changes.- 6. Calculi and foreign bodies.- 7. Tumours.- 8. Influence of extravesical processes.- 9. Endometriosis of the bladder.- 10. Bladder fistulas.- 11. Changes due to urinary obstruction.- 12. Vesico-ureteric reflux.- 13. The neurogenic bladder. — Nocturnal enuresis.- V. The male urethra and its adnexa.- 1. Normal anatomy.- 2. Developmental anomalies of the urethra.- 3. Positional changes of the urethra.- 4. Traumatic lesions of the urethra.- 5. Inflammatory changes in the urethra.- 6. Urethral stricture.- 7. Stones and foreign bodies in the urethra.- 8. Tumours of the urethra.- 9. Urethral fistulas.- 10. The prostate and prostatic utricle: normal anatomy.- 11. Prostatic calculi.- 12. Prostatitis.- 13. Dilatation of the prostatic utricle. — Utriculitis and haemospermia.- 14. Cowperitis.- 15. The inflammatory complex of the urethra and its adnexa. — Pelvospondylitis and symphysitis.- 16. Tumours of the prostate.- 17. Hypertrophy of the prostate.- 18. Vesical-neck contraction.- 19. Postoperative changes in the posterior urethra. — False passages in the prostatic region.- VI. The female urethra.- 1. Urethrocystographic technique and normal anatomy.- 2. Urethritis, urethral diverticula, diverticulitis.- 3. Cystocele and stress incontinence.- VII. Urethrocystography in children.- VIII. Vaso-vesiculo-epididymography.- Diagnostic vesiculography.- IX. Angiography of the bladder, urethra and male genital organs.- References.- Diagnostic radioactive isotopes in urology..- A. Diagnostic tests of organ function.- I. The radioisotope renogram.- II. Estimation of renal blood flow with radioisotopes.- III. Vesical-ureteral reflux.- B. Cancer detection.- I. Radioactive zinc in the prostate and prostatic fluid.- II. Attempts to localize metastatic lesions of the prostate with P-32.- C. Fluid and electrolyte exchange.- I. Electrolytes.- II. Renal lymphatics studied with isotopes.- III. Effect of hormones on renal clearance of radioiodine in the rat.- IV. The transfer of irrigating fluid during transurethral prostectomy.- V. Aortography timing.- VI. I-131 labelled sodium acetriozoate in excretory urography.- D. Diagnostic radioautography.- I. Renal autography.- II. The localization of sodium in the rat kidney.- III. Use of 1–131 and colloidal Au-198 to study the route of urine in acute hydronephrosis in dogs.- References.- Author Index.