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What Do The Following CT Scan Report Indicate?
Question: Dear Dr,
I have attached the CT-Scan report... Please advice...
CT – KUB (PLAIN AND CONTRAST)
STUDY PROTOCOL:
Axial 5mm cuts were obtained from the proximal pole of the kidneys down to the symphysis pubis and these were repeated during the dynamic intravenous administration of 60 cc Iohexol 300. Delayed images were obtained to assess the excretory function.
FINDINGS:
Right kidney:
Measures 10.4cm x 5.4cm. Cortical thickness measures 21mm.
Appear normal in size and position, with normal width and density of renal parenchyma.
The calices are of normal shape. The renal pelvis is normal and free of stones, and there is no obstruction of urinary drainage.
The ureters are not dilated.
Contrast - enhanced scans show a normal time to corticomedullary equilibrium and timely, symmetrical contrast excretion into the renal pelves with no filling defects.
Left kidney:
Measures 13.6cm x 8.1cm. Cortical thickness measures 5mm.
Gross dilatation of pelvicalyceal system with abrupt narrowing of pelviureteric junction and severe cortical parenchymal thinning.
The ureters are not dilated
Contrast - Thin cortical nephrogram with no significant contrast excretion into dilated pelvicalyceal system.
The perirenal and pararenal spaces are unremarkable.
Urinary bladder: The bladder shows smooth outer contours and normal wall thickness.
No intravesical mass or calculus is seen.
No retroperitoneal or mesenteric lymphadenopathy is seen.
There is no free or loculated peritoneal fluid collection.
The pelvic inlet appears normal, with normal configuration of the iliac wings and iliopsoas muscles.
Uterus and ovaries are normal.
The ischiorectal fossae are unremarkable.
No major abnormality of the vertebral column or the bony pelvis is seen.
Visualized sections of liver, spleen and pancreas do not reveal any abnormality.
Both adrenal glands present normal size and position with normally developed crura. There is no evidence of a mass and no circumscribed expansion.
IMPRESSION:
« Left kidney: Gross dilatation of pelvicalyceal system with abrupt narrowing of pelviureteric junction and severe cortical parenchymal thinning.
Contrast - Thin cortical nephrogram with no significant contrast excretion into dilated pelvicalyceal system à Features suggestive of SEVERE PELVIURETERIC JUNCTION OBSTRUCTION.
« NO SIGNIFICANT ABNORMALITY DETECTED IN RIGHT KIDNEY, URINARY BLADDER AND PELVIS
I have attached the CT-Scan report... Please advice...
CT – KUB (PLAIN AND CONTRAST)
STUDY PROTOCOL:
Axial 5mm cuts were obtained from the proximal pole of the kidneys down to the symphysis pubis and these were repeated during the dynamic intravenous administration of 60 cc Iohexol 300. Delayed images were obtained to assess the excretory function.
FINDINGS:
Right kidney:
Measures 10.4cm x 5.4cm. Cortical thickness measures 21mm.
Appear normal in size and position, with normal width and density of renal parenchyma.
The calices are of normal shape. The renal pelvis is normal and free of stones, and there is no obstruction of urinary drainage.
The ureters are not dilated.
Contrast - enhanced scans show a normal time to corticomedullary equilibrium and timely, symmetrical contrast excretion into the renal pelves with no filling defects.
Left kidney:
Measures 13.6cm x 8.1cm. Cortical thickness measures 5mm.
Gross dilatation of pelvicalyceal system with abrupt narrowing of pelviureteric junction and severe cortical parenchymal thinning.
The ureters are not dilated
Contrast - Thin cortical nephrogram with no significant contrast excretion into dilated pelvicalyceal system.
The perirenal and pararenal spaces are unremarkable.
Urinary bladder: The bladder shows smooth outer contours and normal wall thickness.
No intravesical mass or calculus is seen.
No retroperitoneal or mesenteric lymphadenopathy is seen.
There is no free or loculated peritoneal fluid collection.
The pelvic inlet appears normal, with normal configuration of the iliac wings and iliopsoas muscles.
Uterus and ovaries are normal.
The ischiorectal fossae are unremarkable.
No major abnormality of the vertebral column or the bony pelvis is seen.
Visualized sections of liver, spleen and pancreas do not reveal any abnormality.
Both adrenal glands present normal size and position with normally developed crura. There is no evidence of a mass and no circumscribed expansion.
IMPRESSION:
« Left kidney: Gross dilatation of pelvicalyceal system with abrupt narrowing of pelviureteric junction and severe cortical parenchymal thinning.
Contrast - Thin cortical nephrogram with no significant contrast excretion into dilated pelvicalyceal system à Features suggestive of SEVERE PELVIURETERIC JUNCTION OBSTRUCTION.
« NO SIGNIFICANT ABNORMALITY DETECTED IN RIGHT KIDNEY, URINARY BLADDER AND PELVIS
Brief Answer:
There is damage to left kidney due to longstanding urinary obstruction
Detailed Answer:
Hi,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. The right kidney is normal.
2. The left kidney shows a significant stricture or narrowing in the area where the kidney collecting system continues as the ureter and called as pelviureteric junction. The ureter is a thin tubular structure that connects the kidney above to the urinary bladder below.
3. Due to the above stricture in left pelviureteric junction there is thinning and destruction of kidney tissue. This is because of obstruction of urine flow and retention which has caused permanent damage to left kidney. It is also noted that the left kidney is not functioning properly.
4. It is not clear how and when the narrowing happened and this might have been there for months to cause the damage in the left kidney as seen in the report.
5. The right kidney is showing normal functioning.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
Dr.Vivek
There is damage to left kidney due to longstanding urinary obstruction
Detailed Answer:
Hi,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. The right kidney is normal.
2. The left kidney shows a significant stricture or narrowing in the area where the kidney collecting system continues as the ureter and called as pelviureteric junction. The ureter is a thin tubular structure that connects the kidney above to the urinary bladder below.
3. Due to the above stricture in left pelviureteric junction there is thinning and destruction of kidney tissue. This is because of obstruction of urine flow and retention which has caused permanent damage to left kidney. It is also noted that the left kidney is not functioning properly.
4. It is not clear how and when the narrowing happened and this might have been there for months to cause the damage in the left kidney as seen in the report.
5. The right kidney is showing normal functioning.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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