Nephrographic and pyelographic analysis of CT urography: differential diagnosis.

OBJECTIVE: The differential diagnosis of renal disease is extensive. The purpose of this article is to enable the reader to recognize and understand the abnormal nephrographic patterns encountered in practice. CONCLUSION: Recognizing the different nephrographic patterns on CT urography can be invaluable in understanding the morphologic and physiologic condition of the kidney and ultimately diagnosing the disease process.

Nephrographic and pyelographic analysis of CT urography: principles, patterns, and pathophysiology.

OBJECTIVE: Careful analysis of the nephrogram is an integral component of the evaluation of the kidneys during CT urography. This is a review of the anatomy and physiology required to produce a normal nephrogram, as well as the basic principles affecting the interpretation of the nephrogram. CONCLUSION: The eight abnormal nephrographic patterns will be illustrated and discussed. This review will enable the reader to recognize and understand the abnormal nephrographic patterns encountered in practice.

Aggressive Metastatic Translocation Renal Carcinoma in a 23-year-old Man.

Translocation renal carcinomas are a rare subtype of renal cell carcinoma that typically occurs in young patients, especially those who have received prior chemotherapy. We present the case of a 23-year-old man with abdominal pain, nausea vomiting and neck swelling. Contrast enhanced computed tomography (CECT) of the neck, chest, abdomen and pelvis showed extensive left supraclavicular adenopathy, as well as extensive retroperitoneal adenopathy, displacing the pancreas superiorly, as well as encasing the aorta.

From the RSNA refresher courses: a practical approach to the cystic renal mass.

The pathologic and imaging features of the renal cyst have been well described. A fluid-filled lesion is considered a cystic mass (ie, not a simple cyst) when it has any of the following features: calcification, high attenuation (>20 HU) at computed tomography, signal intensity not typical of water at magnetic resonance imaging, septations, multiple locules, enhancement, wall thickening, or nodularity. There are two important causes of a cystic renal mass: a complicated simple cyst (eg, one with hemorrhage, infection, or ischemia) and cystic renal cell carcinoma. At radiologic evaluation of such masses, it is imperative that optimal imaging techniques be used. Masses with calcification, high attenuation or high signal intensity, or septations can be categorized as benign (no further evaluation required), as requiring follow-up (probably benign), or as requiring surgery. Lesions requiring surgery can be benign or malignant at microscopic examination. Lesions that are multiloculated or demonstrate enhancement, wall thickening, or nodularity usually require surgery. When multiple features are present (eg, calcification and enhancement), the mass should be managed according to its most aggressive feature. Likewise, when there are conflicting findings at evaluation with different imaging modalities, the mass should be managed according to the most aggressive finding.