Kidney Diseases Diagnosis: Tumors, Renal Failure, Stones - Ultrasound, CT Urography - When to use?
MRI of kidneys to diagnose cancer / renal cell carcinoma. Dr. Anton Titov, MD: To stay in the abdominal area, let's touch upon MRI and CT studies of the kidneys and adrenal glands. When kidney MRI or kidney CT is indicated? When it can benefit someone with a known or suspected kidney disease?
Dr. Kent Yucel: Kidney disease really falls into three categories. There's disease of the kidney itself. It causes the kidneys to fail. That's usually evaluated by kidney biopsy and there's very little role for imaging in kidney diseases of that kind.
We call that diffuse or medical kidney disease. Then there's kidney tumors. Renal tumors generally present with blood in the urine blood that you can't see. Maybe blood that is only detectable by looking at the urine under the microscope.
Dr. Anton Titov, MD: Painless hematuria. Dr. Kent Yucel, MD: Painless hematuria we call that. Those tumors can be diagnosed by imaging. Ultrasound is usually the first choice. But ultrasound also can miss small tumors.
So many older people have blood in their urine, they may have renal CT or MRI scan even if ultrasound of kidneys is normal.
And the third area of kidney disease is blockage of the urine coming out the kidneys going into the bladder. That tube that leads from the kidneys into the bladder is called a ureter. So something is blocking of a ureter.
The name for it is hydronephrosis, or water distention of the kidney. And that is evaluated by ultrasound primarily. And similar to the bile duct situation, the ultrasound is very good at showing blockage. But ultrasound is not so good at showing the cause of blockage.
If there is no blockage then patients are generally done with that imaging of kidney. But if ultrasound shows blockages then they will generally go on to the next diagnostic step. which is the CT or MRI of the kidneys. It can show what is causing the blockage.
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