• Title/Summary/Keyword: Renal imaging

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Guidelines for childhood urinary tract infection (소아 요로감염의 임상 지침)

  • Lee, Seung Joo
    • Clinical and Experimental Pediatrics
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    • v.52 no.9
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    • pp.976-983
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    • 2009
  • Urinary tract infection (UTI), the most common bacterial disease in childhood, is frequently associated with urinary tract anomalies (15-50%) and can induce renal scarring, which is a cause of hypertension and chronic kidney disease. Despite the high risk of renal scarring in infancy, the diagnosis may be delayed due to its nonspecific presenting symptoms; moreover, over-diagnosis is frequent due to the contamination of urine samples. The delay in diagnosis and treatment may induce sepsis or renal scar, while over-diagnosis is responsible for unnecessary antibiotic treatment and costly urinary imaging studies. UTI guidelines have been ever-changing for the past three decades, but some controversial issues remain. This article is a revision of the previous KSPN (Korean Society of Pediatric Nephrology) guideline and addresses the recent controversies concerning childhood UTI.

Diagnostic Imaging of Urological Diseases in Dogs (개에서 비뇨기계 질환의 진단영상)

  • 장동우;정주현;장진회;정우조;원성준;이기창;최호정;이희천;윤화영
    • Journal of Veterinary Clinics
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    • v.18 no.4
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    • pp.459-464
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    • 2001
  • Excretory urography is a procedure where opacification of the kidneys, renal pelvic diverticula, ureters, and urinary bladder is a result of renal excretion of an intravenously administered iodinated contrast agent providing both anatomical and functional assessment. And ultrasonography is a non-invasive modality to evaluate the important anatomic information concerning the size, shape, and internal architecture of kidney even in the presence of impaired renal function or abdominal fluid. We describe four dogs with urological signs diagnosed with excretory urography and ultrasonography. Parients showed a variety of clinical signs including vomiting, hematuria, anorexia, abdominal pain, and abdominal distension. The hydronephrosis was diagnosed in case 1, 2, and 3 that had pelvic dilation, dilation of pelvic recesses, ureteral dilation. In case 3, proximal ureteral rupture was diagnosed with evidence of contrast media leakage was seen in proximal ureter. In case 4, the rupture of urinary bladder was diagnosed with leakage of contrast media through its ventral portion.

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Preoperative Assessment of Renal Sinus Invasion by Renal Cell Carcinoma according to Tumor Complexity and Imaging Features in Patients Undergoing Radical Nephrectomy

  • Ji Hoon Kim;Kye Jin Park;Mi-Hyun Kim;Jeong Kon Kim
    • Korean Journal of Radiology
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    • v.22 no.8
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    • pp.1323-1331
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    • 2021
  • Objective: To identify the association between renal tumor complexity and pathologic renal sinus invasion (RSI) and evaluate the usefulness of computed tomography tumor features for predicting RSI in patients with renal cell carcinoma (RCC). Materials and Methods: This retrospective study included 276 consecutive patients who underwent radical nephrectomy for RCC with a size of ≤ 7 cm between January 2014 and October 2017. Tumor complexity and anatomical renal sinus involvement were evaluated using two standardized scoring systems: the radius (R), exophytic or endophytic (E), nearness to collecting system or sinus (N), anterior or posterior (A), and location relative to polar lines (RENAL) nephrometry and preoperative aspects and dimensions used for anatomical classification (PADUA) system. CT-based tumor features, including shape, enhancement pattern, margin at the interface of the renal sinus (smooth vs. non-smooth), and finger-like projection of the mass, were also assessed by two independent radiologists. Univariable and multivariable logistic regression analyses were performed to identify significant predictors of RSI. The positive predictive value, negative predictive value (NPV), accuracy of anatomical renal sinus involvement, and tumor features were evaluated. Results: Eighty-one of 276 patients (29.3%) demonstrated RSI. Among highly complex tumors (RENAL or PADUA score ≥ 10), the frequencies of RSI were 42.4% (39/92) and 38.0% (71/187) using RENAL and PADUA scores, respectively. Multivariable analysis showed that a non-smooth margin and the presence of a finger-like projection were significant predictors of RSI. Anatomical renal sinus involvement showed high NPVs (91.7% and 95.2%) but low accuracy (40.2% and 43.1%) for RSI, whereas the presence of a non-smooth margin or finger-like projection demonstrated comparably high NPVs (90.0% and 91.3% for both readers) and improved accuracy (67.0% and 73.9%, respectively). Conclusion: A non-smooth margin or the presence of a finger-like projection can be used as a preoperative CT-based tumor feature for predicting RSI in patients with RCC.

Glomerular Filtration Rate Determined in Conjunction with $^{99m}TC-DTPA$ Routine Renal Scintigraphy (통상적 $^{99m}TC-DTPA$ 신장스캔을 이용한 GFR 측정)

  • Yi, Gang-Wook;Han, Jin-Suk;Chung, June-Key;Lee, Myung-Chul;Lee, Jung-Sang;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.23 no.1
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    • pp.49-54
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    • 1989
  • Many previously described nuclear medicine procedures to assess glomerular filtration rate (GFR) required numerous blood samples obtained over a period of several hours to determine plasma concentrations of the injected radiopharmaceuticals. And other indirect methods of determining renal clearance have some problems due to individual variations in volume of distribution of the radionuclides used. Rescently reported Jackson's method have the great advantages that is a direct measurement method requiring less than 40 min of imaging time and single blood sampling. And it correctly accounts for individual variations in volume of distribution of the radiopharmaceuticals and can be done with routine renal scintrgraphy. We measured $^{99m}Tc-DTPA$ renal clearance with Jackson's method during the routine $^{99m}Tc-DTPA$ renal scintigraphy in 63 patients admitted to department of internal medicine in SNUH. In 23 cases among 63 patients creatinine clearence was accounted simultaneously. The range of $Cl_{DPDA}$ was from 19.9 ml/min to 170 ml/min and the correlation of $Cl_{DPDA}$ and creatinine clearance was discribed by Y=16.2570+0.7852 X($X=Cl_{DTPA}$ Y=creatinine clearance). And the correlation coefficient r was 0.88. We concluded that $^{99m}Tc-DTPA$ renal clearance measurement with Jackson's method was clinically useful to account GFR that can be done with routine $^{99m}Tc-DTPA$ renal scintigraphy simultaneously.

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Diagnostic imaging features of calyceal diverticulum in a cat

  • Nam, Yunjeong;Lee, Youngwon;Choi, Hojung
    • Korean Journal of Veterinary Research
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    • v.61 no.2
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    • pp.17.1-17.4
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    • 2021
  • A seven-year-old, castrated male, Korean domestic shorthair cat was referred because of a kidney abnormality. Radiography revealed left renal agenesis and right kidney enlargement. Ultrasonography and computed tomography (CT) showed amorphous calcified materials in a cyst-like lesion of the right kidney. In the excretory phase of the CT images, the lesion was opacified with contrast materials, indicating communication with the collecting system. Based on these findings, the cat was diagnosed with a calyceal diverticulum. A calyceal diverticulum may cause various clinical symptoms related to the urinary system. The excretory phase of CT is useful for diagnosing a calyceal diverticulum.

A Case of Seminal Vesicle Cyst Accompanied with Ipsilateral Renal Agenesis in an Infant (영아에서 발견된 동측 신무형성증과 동반된 정낭낭종 1례)

  • Yun, Jin-Sang;Chang, Sun-Jung;Lee, Jun-Ho
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.252-255
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    • 2009
  • Seminal vesicle cysts have been rarely detected. Most of them are caused congenitally, and two-thirds of them are accompanied with ipsilateral renal agenesis or dysplasia. They are usually present with dysuria, urinary frequency, perineal pain, epididymitis, pain after ejaculation, scrotal pain or infertility in the second to fourth decade of patient's life. Occasionally cysts are palpable by digital rectal examination, but radiologic imaging study is necessary to diagnose. We report a case of an infant with seminal vesicle cyst accompanied with ipsilateral renal agenesis detected incidentally in postnatal sonogram. The infant's right side of kidney was diagnosed as antenatally multicystic dysplastic kidney.

Mandibular brown tumor in renal osteodystrophy

  • Park, Jin-Woo;Choi, Bo-Ram;Gang, Tae-In;Huh, Kyung-Hoe;Yi, Won-Jin;Choi, Soon-Chul
    • Imaging Science in Dentistry
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    • v.38 no.4
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    • pp.229-231
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    • 2008
  • Brown tumor is a histologically benign lesion that is a serious complication of renal osteodystrophy because it may result in severe deformity and discomfort. We report a case of brown tumor, which occurred in a 35-year-old woman with chronic renal failure, who had been treated with hemodialysis for 14 years. The lesion was found on the lingual side of the mandible. Standard panoramic radiograph showed generally decreased bone mineral density, loss of lamina dura, and thin cortical plates. Computed tomography (CT) revealed multilocular expansile lesions with heterogeneous attenuation in the anterior mandible, as well as generalized trabecular alteration with homogeneous sclerosis, and thinning or obliteration of cortical plates. Excision of the mandibular lesion and curettage of the affected bone were performed. (Korean J Oral Maxillofac Radiol 2008; 38: 229-31)

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Rapid Development of Diffuse Myocardial Calcification in a Patient after Recovery from Sepsis and Renal Failure: A Case Report (패혈증과 신부전에서 회복된 환자에서 급속하게 발생한 미만성 심근 석회화: 증례 보고)

  • Mi Hyun Kang;Song Soo Kim;Byung Joo Sun;Jae-Hyeong Park
    • Journal of the Korean Society of Radiology
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    • v.83 no.5
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    • pp.1104-1108
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    • 2022
  • Myocardial calcification can develop owing to several conditions. It is a rare complication following sepsis and renal failure. We report a case of rapid development of left ventricular mid-wall calcification observed using CT and cardiac MRI in a patient after recovery from sepsis and acute renal failure.

Renal Localization of Ga-67 Citrate in Noninfectious Nephritis (비세균성 신염환자에서 신장내 $^{67}Ga-Citrate$ 흡수에 관한 연구)

  • Lee, Kang-Wook;Jeong, Min-Soo;Rhee, Sunn-Kgoo;Kim, Sam-Yong;Shin, Young-Tai;Ro, Heung-Kyu
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.2
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    • pp.318-326
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    • 1992
  • Ga-67 citrate scan has been requested for detection or follow-up of inflammatory or neoplastic disease. Visualization of Ga-67 citrate in the kidneys at 48 and 72 hr post injection is usually interpreted as evidence of renal pathology. But precise mechanisms of abnormal Ga-67 uptake in kidneys were unknown. We undertook a study to determine the clinical value of Ga-67 citrate imaging of the kidneys in 68 patients with primary or secondary nephropathy confirmed by renal biopsy and 66 control patients without renal disease. Renal uptake in 48 to 72 hr images was graded as follows: Grade 0=back-ground activity:1=faint uptake greater than background;2=definite uptake, but less than lumbar vertebrae; 3=same uptake as lumbar vertebrae, but less than liver; 4=same or higher uptake than liver. The results were as follows. 1) 42 of 65 (62%) patients with noninfectious nephritis showed grade 2 or higher Ga-67 renal uptake but only 10 percent of control patients showed similar uptake. 2) In 14 patients with systemic lupus erythematosus, 8 of 9 (89%) patients with lupus nephritis exhibited marked renal uptake 3) 36 of 41 patients (88%) with combined nephrotic syndrome showed Grade 2 or higher renal uptake. 4) Renal Ga-67 uptake was correlated with clinical severity of nephrotic syndrome determined by serum albumin level, 24 hr urine protein excretion and serum lipid levels. 5) After complete remission of nephrotic syndrome, renal uptake in all 8 patients who were initially Grade 3 or 4, decreased to Grade 1 or 0. In conclusion, we think that the mechanism of renal Ga-67 uptake in nephrotic syndrome might be related to the pathogenesis of nephrotic syndrome. In systemic lupus erythematosus, Ga-67 citrate scan is useful in predicting renal involvement.

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