Diagnostic Imaging: Genitourinary

Dr. Bryan Foster is a body imaging radiologist with a subspecialty focus on oncologic, hepatobiliary, pancreatic, prostate, and small bowel imaging. Dr. Foster is the director of ultrasound at OHSU and performs complex image-guided biopsies; he also performs CEUS imaging and US elastography. Dr. Foster is skilled in all facets of imaging including radiography, fluoroscopy, ultrasound, CT, and MRI. His interests include oncologic, hepatobiliary, pancreatic, prostate, and small bowel imaging. Dr. Foster has recently started performing contrast-enhanced ultrasound imaging (as the only site in Oregon) and US elastography. He is one of two radiologists that perform MRI-guided prostate biopsies (also only site in Oregon). Recently he was selected as an Honored Educator for the Radiological Society of North America. Ghaneh Fananapazir, MD is an Associate Professor and Director of Ultrasound at UC Davis Medical Center in Sacramento, CA. His interests include abdominal radiology in plain films, intravenous pyelograms, retrograde urethrograms, hysterosalpingograms, ultrasound, CT, and both anatomical and functional MRI. He also performs nonvascular interventional procedures including renal biopsy, cyst or abscess drainage, and nephrostomy tube placement. Dr. Fananapazir is the new co-lead author of Diagnostic Imaging: Genitourinary, 4e.

SECTION 1: OVERVIEW AND INTRODUCTION 4 Imaging Approaches Bryan R. Foster, MD and Ghaneh Fananapazir, MD SECTION 2: RETROPERITONEUM 12 Introduction to Retroperitoneum Bryan R. Foster, MD and Matthew T. Heller, MD, FSAR

CONGENITAL 16 Duplications and Anomalies of IVC Bryan R. Foster, MD and Matthew T. Heller, MD, FSAR

INFLAMMATION 20 Retroperitoneal Fibrosis Alice Fung, MD and Matthew T. Heller, MD, FSAR

DEGENERATIVE 24 Pelvic Lipomatosis Bryan R. Foster, MD and Matthew T. Heller, MD, FSAR

TREATMENT RELATED 26 Retroperitoneal Hemorrhage Alice Fung, MD and Matthew T. Heller, MD, FSAR 30 Postoperative Lymphocele Alice Fung, MD and Matthew T. Heller, MD, FSAR

BENIGN NEOPLASMS 32 Retroperitoneal Neurogenic Tumor Bryan R. Foster, MD and Matthew T. Heller, MD, FSAR

MALIGNANT NEOPLASMS 36 Retroperitoneal Sarcoma Alice Fung, MD 40 Retroperitoneal and Mesenteric Lymphoma Alice Fung, MD and Matthew T. Heller, MD, FSAR 44 Retroperitoneal Metastases Bryan R. Foster, MD and Matthew T. Heller, MD, FSAR 48 Solitary Fibrous Tumor Bryan R. Foster, MD

SECTION 3: ADRENAL 52 Introduction to Adrenals Mitchell Tublin, MD, Ghaneh Fananapazir, MD, and Michael P. Federle, MD, FACR INFECTION 56 Adrenal Tuberculosis and Fungal Infection Mitchell Tublin, MD and Michael P. Federle, MD, FACR

METABOLIC OR INHERITED 58 Adrenal Hyperplasia Ghaneh Fananapazir, MD 60 Adrenal Insufficiency Mitchell Tublin, MD and Michael P. Federle, MD, FACR

TRAUMA 62 Adrenal Hemorrhage Ghaneh Fananapazir, MD, Mitchell Tublin, MD, and Michael P. Federle, MD, FACR

BENIGN NEOPLASMS 66 Adrenal Cyst Mitchell Tublin, MD 70 Adrenal Adenoma Mitchell Tublin, MD and Mark D. Sugi, MD 76 Adrenal Myelolipoma Mitchell Tublin, MD and Michael P. Federle, MD, FACR 80 Pheochromocytoma Mitchell Tublin, MD and Mark D. Sugi, MD MALIGNANT NEOPLASMS 86 Adrenal Cortical Carcinoma Mitchell Tublin, MD, Ghaneh Fananapazir, MD, and Michael P. Federle, MD, FACR 90 Adrenal Cortical Carcinoma Staging Akram M. Shaaban, MBBCh 102 Adrenal Lymphoma Mitchell Tublin, MD and Mark D. Sugi, MD 104 Adrenal Metastases Mitchell Tublin, MD and Mark D. Sugi, MD 108 Adrenal Collision Tumor Mitchell Tublin, MD and Mark D. Sugi, MD

SECTION 4: KIDNEY AND RENAL PELVIS 112 Introduction to Renal Physiology and Contrast Alessandro Furlan, MD and Ghaneh Fananapazir, MD 114 Introduction to Kidney and Renal Pelvis Alessandro Furlan, MD

NORMAL VARIANTS AND PSEUDOLESIONS 120 Renal Fetal Lobation Amir A. Borhani, MD and Michael P. Federle, MD, FACR 122 Junctional Cortical Defect Amir A. Borhani, MD 124 Column of Bertin Amir A. Borhani, MD and Michael P. Federle, MD, FACR

CONGENITAL 126 Horseshoe Kidney Alessandro Furlan, MD, Mark D. Sugi, MD, and Michael P. Federle, MD, FACR 130 Renal Ectopia and Agenesis Alessandro Furlan, MD, Michael P. Federle, MD, FACR, and Mark D. Sugi, MD 134 Ureteropelvic Junction Obstruction Alessandro Furlan, MD and Michael P. Federle, MD, FACR 138 Congenital Megacalyces and Megaureter Alessandro Furlan, MD and Ghaneh Fananapazir, MD 140 Renal Lymphangiomatosis Alessandro Furlan, MD and Ghaneh Fananapazir, MD

INFECTION 142 Acute Pyelonephritis Ghaneh Fananapazir, MD and Alessandro Furlan, MD 146 Chronic Pyelonephritis/Reflux Nephropathy Alessandro Furlan, MD and Amir A. Borhani, MD 148 Xanthogranulomatous Pyelonephritis Lori Mankowski Gettle, MD, MBA, FSRU, Alessandro Furlan, MD, and R. Brooke Jeffrey, MD 152 Emphysematous Pyelonephritis Lori Mankowski Gettle, MD, MBA, FSRU, Alessandro Furlan, MD, and R. Brooke Jeffrey, MD 154 Renal Abscess Lori Mankowski Gettle, MD, MBA, FSRU, Alessandro Furlan, MD, and R. Brooke Jeffrey, MD 158 Pyonephrosis Lori Mankowski Gettle, MD, MBA, FSRU and Alessandro Furlan, MD 160 Opportunistic Renal Infections Alessandro Furlan, MD and Amir A. Borhani, MD RENAL CYSTIC DISEASE 162 Renal Cyst Kanupriya Vijay, MD and Alessandro Furlan, MD 166 Parapelvic (Peripelvic) Cyst Kanupriya Vijay, MD and Alessandro Furlan, MD 168 Bosniak Classification of Cystic Masses Benjamin Wildman-Tobriner, MD and Kevin Kalisz, MD 172 Autosomal Dominant Polycystic Kidney Disease Bryan R. Foster, MD and Alessandro Furlan, MD 176 Acquired Cystic Kidney Disease Ghaneh Fananapazir, MD and Alessandro Furlan, MD 178 von Hippel-Lindau Disease Alessandro Furlan, MD and Mark D. Sugi, MD 182 Medullary Cystic Diseases Ghaneh Fananapazir, MD and Michael P. Federle, MD,

FACR 184 Lithium Nephropathy Lori Mankowski Gettle, MD, MBA, FSRU, Alessandro Furlan, MD, and Amir A. Borhani, MD 186 Localized Cystic Renal Disease Alessandro Furlan, MD and Michael P. Federle, MD, FACR BENIGN NEOPLASMS 188 Renal Angiomyolipoma Lori Mankowski Gettle, MD, MBA, FSRU and Matthew T. Heller, MD, FSAR 194 Renal Oncocytoma Lori Mankowski Gettle, MD, MBA, FSRU and Matthew T. Heller, MD, FSAR 198 Metanephric Adenoma Lori Mankowski Gettle, MD, MBA, FSRU, Ghaneh Fananapazir, MD, and Matthew T. Heller, MD, FSAR 200 Mixed Epithelial and Stromal Tumor Family Ghaneh Fananapazir, MD and Matthew T. Heller, MD,

FSAR INFLAMMATION 202 IgG4 Renal Disease Kevin Kalisz, MD and Benjamin Wildman-Tobriner, MD 206 Histiocytic Diseases Bryan R. Foster, MD

MALIGNANT NEOPLASMS 208 Renal Cell Carcinoma Matthew T. Heller, MD, FSAR 214 Renal Cell Carcinoma Staging Lori Mankowski Gettle, MD, MBA, FSRU and Douglas Rogers, MD 234 Medullary Carcinoma Kevin Kalisz, MD 236 Collecting Duct Carcinoma Kevin Kalisz, MD 238 Urothelial Carcinoma Lori Mankowski Gettle, MD, MBA, FSRU and Matthew T. Heller, MD, FSAR 242 Renal Pelvis and Ureter Carcinoma Staging Akram M. Shaaban, MBBCh 260 Renal Lymphoma Lori Mankowski Gettle, MD, MBA, FSRU and Matthew T. Heller, MD, FSAR 262 Renal Metastases Matthew T. Heller, MD, FSAR

METABOLIC 264 Nephrocalcinosis Kevin Kalisz, MD 268 Urolithiasis Matthew T. Heller, MD, FSAR 272 Paroxysmal Nocturnal Hemoglobinuria Matthew T. Heller, MD, FSAR

RENAL FAILURE AND MEDICAL RENAL DISEASE 274 Hydronephrosis Lori Mankowski Gettle, MD, MBA, FSRU and Alessandro Furlan, MD 276 Glomerulonephritis Ghaneh Fananapazir, MD and Michael P. Federle, MD, FACR 278 Acute Tubular Injury Alessandro Furlan, MD 280 Renal Cortical Necrosis Benjamin Wildman-Tobriner, MD 282 Renal Papillary Necrosis Kevin Kalisz, MD 284 HIV Nephropathy Alessandro Furlan, MD and Ghaneh Fananapazir, MD 286 Chronic Renal Failure Alessandro Furlan, MD 288 Renal Lipomatosis Alessandro Furlan, MD, Amir A. Borhani, MD, and Ghaneh Fananapazir, MD

VASCULAR DISORDERS 290 Renal Artery Stenosis Amir A. Borhani, MD and Kanupriya Vijay, MD 294 Renal Infarction Kanupriya Vijay, MD and Amir A. Borhani, MD 300 Renal Vein Thrombosis Kanupriya Vijay, MD and Amir A. Borhani, MD 304 Renal Vasculitis Bryan R. Foster, MD

TRAUMA 306 Renal Trauma Matthew T. Heller, MD, FSAR and Ghaneh Fananapazir, MD 310 Urinoma Matthew T. Heller, MD, FSAR

TRANSPLANTATION 312 Kidney Transplant Normal Anatomy Ghaneh Fananapazir, MD 316 Vascular Thrombosis in Kidney Transplants Ghaneh Fananapazir, MD 320 Transplant Renal Artery Stenosis Ghaneh Fananapazir, MD 324 Arteriovenous Fistulas Involving Kidney Transplants Ghaneh Fananapazir, MD 326 Pseudoaneurysms Involving Kidney Transplants Ghaneh Fananapazir, MD 328 Urinary Obstruction Involving Kidney Transplants Ghaneh Fananapazir, MD 330 Perinephric Fluid Collections Involving Kidney

Transplants Ghaneh Fananapazir, MD 334 Posttransplant Lymphoproliferative Disease Involving Kidney Transplants Ghaneh Fananapazir, MD 338 Acute Tubular Necrosis in Kidney Transplants Ghaneh Fananapazir, MD 340 Rejection in Kidney Transplants Ghaneh Fananapazir, MD

TREATMENT RELATED 344 Postoperative State, Kidney Benjamin Wildman-Tobriner, MD 348 Radiation Nephropathy Benjamin Wildman-Tobriner, MD 350 Contrast-Induced Nephropathy Kevin Kalisz, MD, Benjamin Wildman-Tobriner, MD, and Amir A. Borhani, MD

SECTION 5: URETER 356 Introduction to Ureter Bryan R. Foster, MD

CONGENITAL 358 Duplicated and Ectopic Ureter Bryan R. Foster, MD and Amir A. Borhani, MD 362 Ureterocele Bryan R. Foster, MD and Amir A. Borhani,

INFLAMMATION 366 Ureteritis Cystica Bryan R. Foster, MD and Amir A. Borhani, MD 368 Ureteral Stricture Bryan R. Foster, MD and Amir A. Borhani, MD

TRAUMA 370 Ureteral Trauma Bryan R. Foster, MD and Matthew T. Heller, MD, FSAR

NEOPLASMS 374 Fibroepithelial Polyp Bryan R. Foster, MD and Amir A. Borhani, MD 376 Ureteral Urothelial Carcinoma Bryan R. Foster, MD and Amir A. Borhani, MD

MISCELLANEOUS 380 Ureterectasis of Pregnancy Kyle K. Jensen, MD and Amir A. Borhani, MD SECTION 6: BLADDER 384 Introduction to Bladder Kyle K. Jensen, MD, Amir A. Borhani, MD, and Paula J. Woodward, MD CONGENITAL 388 Urachal Anomalies Kyle K. Jensen, MD and Amir A. Borhani, MD

INFECTION 392 Cystitis Kyle K. Jensen, MD and Amir A. Borhani, MD 394 Bladder Schistosomiasis Bryan R. Foster, MD and Amir A. Borhani, MD 396 Malakoplakia Bryan R. Foster, MD and Amir A. Borhani, MD DEGENERATIVE 398 Bladder Calculi Bryan R. Foster, MD and Amir A. Borhani, MD 400 Bladder Diverticulum Bryan R. Foster, MD and Amir A. Borhani, MD 404 Fistulas of Genitourinary Tract Bryan R. Foster, MD and Amir A. Borhani, MD 408 Neurogenic Bladder Bryan R. Foster, MD and Amir A. Borhani, MD

TRAUMA 410 Bladder Trauma Kyle K. Jensen, MD and Matthew T. Heller, MD, FSAR

TREATMENT RELATED 414 Postoperative State, Bladder Benjamin Wildman-Tobriner, MD and Amir A. Borhani,MD

BENIGN NEOPLASMS 418 Inflammatory Myofibroblastic Tumor Bryan R. Foster, MD and Amir A. Borhani, MD 420 Bladder and Ureteral Intramural Masses Bryan R. Foster, MD and Amir A. Borhani, MD

MALIGNANT NEOPLASMS 424 Urinary Bladder Carcinoma Staging Akram M. Shaaban, MBBCh 438 Squamous Cell Carcinoma Bryan R. Foster, MD and Amir A. Borhani, MD 440 Adenocarcinoma Bryan R. Foster, MD and Amir A. Borhani, MD

SECTION 7: URETHRA/PENIS 444 Introduction to Urethra Bryan R. Foster, MD and Paula J. Woodward, MD

NEOPLASMS 446 Urethral Carcinoma Staging Akram M. Shaaban, MBBCh

INFECTION 460 Urethral Stricture Bryan R. Foster, MD and Matthew T. Heller, MD, FSAR 462 Urethral Diverticulum Alice Fung, MD and Matthew T. Heller, MD, FSAR

TRAUMA 466 Urethral Trauma Bryan R. Foster, MD 468 Erectile Dysfunction Matthew T. Heller, MD, FSAR

TREATMENT RELATED 470 Penile and Urethral Implants Bryan R. Foster, MD 474 Gender-Affirming Surgery: Female to Male Kyle K. Jensen, MD 478 Gender-Affirming Surgery: Male to Female Kyle K. Jensen, MD

SECTION 8: TESTES NONNEOPLASTIC CONDITIONS 486 Approach to Scrotal Sonography Bryan R. Foster, MD 488 Cryptorchidism Bryan R. Foster, MD and Paula J. Woodward, MD 490 Testicular Torsion Bryan R. Foster, MD and Shweta Bhatt, MD 494 Segmental Infarction Bryan R. Foster, MD and Mitchell Tublin, MD 496 Tubular Ectasia Alice Fung, MD and Mitchell Tublin, MD 498 Testicular Microlithiasis Alice Fung, MD and Mitchell Tublin, MD

NEOPLASMS 500 Germ Cell Tumors Kyle K. Jensen, MD and Mitchell Tublin, MD 504 Testicular Carcinoma Staging Akram M. Shaaban, MBBCh 520 Stromal Tumors Kyle K. Jensen, MD and Shweta Bhatt, MD 524 Testicular Lymphoma and Leukemia Shweta Bhatt, MD and Kyle K. Jensen, MD 526 Epidermoid Cyst Kyle K. Jensen, MD and Mitchell Tublin, MD

SECTION 9: EPIDIDYMIS 530 Epididymitis Bryan R. Foster, MD and Mitchell Tublin, MD 534 Adenomatoid Tumor Bryan R. Foster, MD and Katherine E. Maturen, MD, MS 536 Spermatocele/Epididymal Cyst Alice Fung, MD and Katherine E. Maturen, MD, MS 538 Sperm Granuloma Alice Fung, MD and Mitchell Tublin, MD

SECTION 10: SCROTUM 542 Hydrocele Bryan R. Foster, MD 544 Varicocele Bryan R. Foster, MD and Mitchell Tublin, MD 546 Pyocele Bryan R. Foster, MD and R. Brooke Jeffrey, MD 548 Inguinal Hernia Bryan R. Foster, MD 554 Fournier Gangrene Bryan R. Foster, MD and Mitchell Tublin, MD 556 Fibrous Pseudotumor of Scrotum Bryan R. Foster, MD and Paula J. Woodward, MD 558 Scrotal Trauma Bryan R. Foster, MD and Mitchell Tublin, MD

SECTION 11: SEMINAL VESICLES 564 Congenital Seminal Vesicle Lesions Bryan R. Foster, MD and Amir A. Borhani, MD 566 Acquired Seminal Vesicle Lesions Bryan R. Foster, MD and Amir A. Borhani, MD

SECTION 12: PROSTATE 570 Prostatitis and Abscess Bryan R. Foster, MD 572 Benign Prostatic Hyperplasia Bryan R. Foster, MD 576 Prostatic Cyst Bryan R. Foster, MD 578 Prostate Carcinoma Bryan R. Foster, MD 584 PI-RADS Lexicon and Usage Bryan R. Foster, MD 594 Prostate Carcinoma Staging Jeffrey Dee Olpin, MD

SECTION 13: PROCEDURES 612 Native and Transplant Kidney Biopsy Zachary B. Jenner, MD and Ghaneh Fananapazir, MD 618 Percutaneous Genitourinary Interventions Matthew T. Heller, MD, FSAR, Ashraf Thabet, MD, and Zachary B. Jenner, MD 630 Kidney Ablation Mitchell Tublin, MD, Ashraf Thabet, MD, and Zachary B. Jenner, MD 640 Kidney Embolization Zachary B. Jenner, MD, Mitchell Tublin, MD, and Ashraf Thabet, MD 650 Venous Sampling and Venography (Renal and Adrenal) Amir A. Borhani, MD, T. Gregory Walker, MD, FSIR, and Zachary B. Jenner, MD