Urogenital Imaging (eBook)

Professor SK Morcos, FRCS, FFRRCSI, FRCR, Consultant Radiologist, Sheffield Teaching Hospitals, NHS Foundation Trust, Department of Diagnostic Imaging, Northern General Hospital, Sheffield, UK (President, European Society of Urological Radiology). Henrik S. Thomsen, Professor of Radiology, University of Copenhagen, Chairman, Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev, DENMARK.

Urogenital Imaging 3
Contents 9
Foreword 15
Preface 17
Contributors 19
1 Adrenal Imaging 23
1.1 Introduction 23
1.2 Cushing’s syndrome 24
1.3 Primary hyperaldosteronism 27
1.4 Pheochromocytoma 30
1.5 Adrenal cortical carcinoma 34
1.6 Adrenal incidentaloma 37
2 Retroperitoneal Masses 43
2.1 Introduction 43
2.2 Retroperitoneal anatomy 43
2.3 Pathological conditions 44
2.4 Primary solid retroperitoneal tumors 44
2.5 Retroperitoneal lymphoma 49
2.6 Cystic retroperitoneal masses 52
2.7 Retroperitoneal metastases 54
2.8 Retroperitoneal fibrosis (Ormond’s disease) 55
2.9 Retroperitoneal fluid collections (traumatic and non-traumatic) 57
References 63
3 Imaging of Renal Artery Stenosis 65
3.1 Introduction 65
3.2 Clinical features 65
3.3 Pathology 67
3.4 Imaging of suspected renal artery stenosis 67
References 73
4 Renal Masses 75
4.1 Introduction 75
4.2 Symptomatic renal carcinoma 75
4.3 Incidental renal masses 77
4.4 Patients with a known cancer (other than RCC) 84
4.5 Renal mass in patients with symptoms 85
4.6 Vascular lesions presenting as a renal mass 90
4.7 Renal mass in patients with cystic disease 94
4.8 Treatment 95
References 95
5 Non-neoplastic Renal Cystic Lesions 97
5.1 Introduction 97
5.2 Classification 97
5.3 Cystic lesions affecting renal cortex 98
5.4 Cystic lesions of renal medulla 102
5.5 Cystic diseases affecting both the cortex and medulla 108
References 119
6 Urological and Vascular Complications Post-renal Transplantation 121
6.1 Introduction 121
6.2 Vascular complications 121
6.3 Urological complications 129
6.4 Ureteric strictures 132
6.5 Post-transplant lymphocele 135
6.6 Delayed graft function (DGF) 138
6.7 Post-transplant bladder malignancy 141
References 142
7 Urinary Tract Injuries 143
7.1 Introduction 143
7.2 Renal trauma 143
7.3 Adrenal trauma 152
7.4 Ureteral trauma 153
7.5 Bladder trauma 155
7.6 Urethral trauma 158
7.7 Penile and scrotal trauma 164
References 169
8 Urinary Tract Infections 171
8.1 Symptomatic urinary tract infection in children 171
8.2 Symptomatic upper urinary tract infection in adults 189
8.3 Emphysematous pyelonephritis 195
8.4 Xanthogranulomatous pyelonephritis 196
8.5 Urinary tract infection in the immunocompromised patient 199
8.6 Tuberculosis 201
8.7 Schistosomiasis 205
8.8 Hydatid disease (echinococcosis) 210
8.9 Urethritis 213
References 215
9 Imaging of the Genitourinary System – Urolithiasis 217
9.1 Introduction 217
9.2 Pathology 217
9.3 Clinical features 219
9.4 Evaluation of patients with suspected urinary stones 220
9.5 Treatment 220
9.6 Imaging 221
References 240
10 Hematuria 241
10.1 Definition 241
10.2 Clinical considerations 241
10.3 Diagnosis of hematuria 242
10.4 Epidemiology 242
10.5 Distribution of malignancy in patients with hematuria 245
10.6 Imaging 245
10.7 Summary 252
References 256
11 Bladder Cancer 257
11.1 Introduction 257
11.2 Clinical features 259
11.3 Pathology 261
11.4 Imaging findings 265
11.5 Treatment planning 275
11.6 Post-treatment Imaging 276
11.7 Summary 276
References 277
12 Imaging of Urinary Diversion 279
12.1 Introduction 279
12.2 Indications for urinary diversion 279
12.3 Types of urinary diversion 279
12.4 Non-continent cutaneous form of diversion 280
12.5 Continent cutaneous urinary diversion (Continent Catheterizing Pouches) 280
12.6 Non-orthotopic continent diversion, relying on the anal sphincter for continence 282
12.7 Orthotopic form of diversion to the native, intact urethra (neobladder) 283
12.8 Contraindications to urinary diversion 286
12.9 Complications of urinary diversions 286
12.10 The role of radiologist in urinary diversion includes 289
12.11 Imaging studies 290
12.12 Imaging of complications 291
12.13 Summary 293
References 293
13 Imaging of the Prostate Gland 295
13.1 Introduction 295
13.2 Zonal anatomy and benign prostatic hypertrophy 295
13.3 Diagnosis of prostate cancer: TRUS features 298
13.4 Diagnostic of prostate cancer: MRI 306
13.5 Contrast-enhanced (dynamic) MRI 307
13.6 Magnetic Resonance Spectroscopic Imaging (MRSI) 312
13.7 Diffusion-weighted imaging 314
13.8 Indications of functional MRI 317
13.9 Extension of prostate cancer 319
13.10 Local extension by TRUS and TRUS-guided biopsy 319
13.11 MRI and staging of prostate cancer 320
13.12 Local staging 321
13.13 Lymph node metastases: lympho-MRI 326
13.14 Bone metastases: whole marrow MRI 326
13.15 Benign disorders of the prostate (BPH excluded) 327
References 343
14 Haemospermia 345
14.1 Introduction 345
14.2 Clinical features 345
14.3 Pathology 347
14.4 Imaging findings 347
14.5 Summary 359
References 359
15 Scrotal Masses 361
15.1 Introduction 361
15.2 Clinical features 361
15.3 Pathology 362
15.4 Imaging 362
15.5 Important principles in assessment of scrotal masses 363
15.6 Important problems in differentiating benign from malignant lesions 367
References 372
16 Gynaecological Adnexal Masses 373
16.1 Introduction 373
16.2 Clinical features 373
16.3 Pathology 374
16.4 Imaging 376
16.5 Standard radiographic techniques 377
16.6 Ultrasound (US) 377
16.7 MR Imaging (MRI) 388
16.8 Computed Tomography 396
References 402
17 Imaging of Abnormal Uterine Bleeding 403
17.1 Abnormal uterine bleeding 403
17.2 Adenomyosis 404
17.3 Leiomyomas 407
17.4 Endometrial polyp 411
17.5 Endometrial hyperplasia 413
17.6 Endometrial carcinoma 416
17.7 Summary 418
References 419
18 Female Pelvic Floor Dysfunction 421
18.1 Introduction 421
18.2 Anatomical considerations 421
18.3 Pathophysiology of pelvic floor dysfunction 423
18.4 Clinical features 423
18.5 Imaging of pelvic floor dysfunction 426
18.6 Magnetic resonance imaging (MRI) 429
References 435
19 Imaging of female infertility 437
19.1 Introduction 437
19.2 Polycystic ovary syndrome 437
19.3 Abnormalities of the fallopian tubes (Hydrosalpinx/Hematosalpinx, tubal block) 440
19.4 Fibroids 443
19.5 Adenomyosis 445
19.6 Developmental anomalies of the uterus 446
19.7 Endometriosis 451
19.8 Imaging 452
Index 453