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Urinary Tract Obstruction and Infection

  • Parvati Ramchandani
  • Harriet C. Thoeny

Abstract

Imaging plays an important role in evaluating patients with both acute and chronic urinary tract obstruction. The cause of obstruction varies greatly with patient population and geographic locale. In a series reporting on percutaneous nephrostomy drainage, urinary obstruction was related to calculus disease in 26% of patients and malignancy in 61%. Carcinoma of the bladder, cervix, and colon were the most common primaries in patients with malignancies and urinary obstruction [1]. Enlarged retroperitoneal and pelvic lymph nodes due to various malignancies, including lymphoma and testicular cancer, can also lead to secondary obstruction.

Keywords

Ureteral Stone Ureteral Obstruction Ureteral Calculus Urinary Tract Obstruction Magnetic Resonance Urography 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Farrell TA, Hicks MS (1997) A review of radiologically guided percutaneous nephrostomies in 303 patients. J Vasc Interv Radiol 8:769–774.PubMedCrossRefGoogle Scholar
  2. 2.
    Hoppe H, Studer R, Kessler TM et al (2006). Alternate or additional findings to stone disease on unenhanced computerized tomography for acute flank pain can impact management. J. Urol 175:1725–30; discussion 1730.PubMedCrossRefGoogle Scholar
  3. 3.
    Katz DS, Scheer M, Lumerman JH et al (2000). Alternative or additional diagnoses on unenhanced helical computed tomography for suspected renal colic: experience with 1000 consecutive examinations. Urology 56:53–57.PubMedCrossRefGoogle Scholar
  4. 4.
    Ahmad NA, Ather MH, Rees J (2003) Incidental diagnosis of diseases on un-enhanced helical computed tomography performed for ureteric colic. BMC Urology 17:2.CrossRefGoogle Scholar
  5. 5.
    Catalano O, Nunziata A, Altei F et al (2002) Suspected ureteral colic: primary helical CT versus selective helical CT after unenhanced radiography and sonography. AJR Am J Roentgenol 178:379–387.PubMedCrossRefGoogle Scholar
  6. 6.
    Boulay I, Holtz P, Foley WD et al (1999) Ureteral calculi: diagnostic efficacy of helical CT and implications for treatment of patients. AJR Am J Roentgenol 172:1485–1490.PubMedCrossRefGoogle Scholar
  7. 7.
    Sheley RC, Semonsen KG, Quinn SF (1999) Helical CT in the evaluation of renal colic. American Journal of Emergency Medicine 17: 279–282.PubMedCrossRefGoogle Scholar
  8. 8.
    Sourtzis S, Thibeau JF, Damry N et al (1999) Radiologic investigation of renal colic: unenhanced helical CT compared with excretory urography. AJR Am J Roentgenol 172: 1491–1494.PubMedCrossRefGoogle Scholar
  9. 9.
    Yilmaz S, Sindel T, Arslan G et al (1998). Renal colic: comparison of spiral CT, US and IVU in the detection ureteral calculi. Eur Radiol 8:212–217.PubMedCrossRefGoogle Scholar
  10. 10.
    Smith RC, Verga M, McCarthy S et al (1996) Diagnosis of acute flank pain: value of unenhanced helical CT. AJR Am J Roentgenol 166:97–101.PubMedCrossRefGoogle Scholar
  11. 11.
    Fielding JR, Silverman SG, Samuel S et al (1998) Unenhanced helical CT of ureteral stones: a replacement for excretory urography in planning treatment. AJR Am J Roentgenol 171:1051–1053.PubMedCrossRefGoogle Scholar
  12. 12.
    Levine JA, Neitlich J, Verga M et al (1997) Ureteral calculi in patients with flank pain: correlation of plain radiography with unenhanced helical CT. Radiology 204:27–31.PubMedCrossRefGoogle Scholar
  13. 13.
    Ciaschini MW, Remer EM, Baker ME et al (2009). Urinary calculi: radiation dose reduction of 50% and 75% at CT — effect on sensitivity. Radiology 251:105–111.PubMedCrossRefGoogle Scholar
  14. 14.
    Katz SI, Saluja S, Brink JA et al (2006). Dose associated with unenhanced CT for suspected renal colic: impact of repetitive studies. AJR Am J Roentgenol 186:1120–1124.PubMedCrossRefGoogle Scholar
  15. 15.
    Kirpalani A, Khalili K, Lee S, Haider MA (2005). Renal colic: comparison of use and outcomes of unenhanced helical CT for emergency investigation in 1998 and 2002. Radiology 236:554–558.PubMedCrossRefGoogle Scholar
  16. 16.
    Ha M, MacDonald RD (2004) Impact of CT scan in patients with first episode of suspected nephrolithiasis. J Emerg Med 27:225–231.PubMedCrossRefGoogle Scholar
  17. 17.
    Kenney PJ (2003) CT evaluation of urinary lithiasis. Radiol Clin N Am 41:979–999.PubMedCrossRefGoogle Scholar
  18. 18.
    LeRoy AJ (2006) Imaging of acute maternal diseases in pregnancy. Categorical course in diagnostic radiology at 92nd scientific assembly and annual meeting, Chicago, IL, RSNA. Genitourinary radiology syllabus 271–279.Google Scholar
  19. 19.
    Fielding JR, Washburn D (2005) Imaging the pregnant patient: a uniform approach. J Women’s Imaging 7:16–21.CrossRefGoogle Scholar
  20. 20.
    Middleton WD, Dodds WJ, Lawson TL, Foley WD (1988) Renal calculi: sensitivity for detection with US. Radiology 167:239–244.PubMedCrossRefGoogle Scholar
  21. 21.
    Sheafor DH, Hertzberg BS, Kelly S (2000) Freed. Nonenhanced helical CT and US in the emergency evaluation of patients with renal colic: prospective comparison. Radiology 217:792–797.PubMedCrossRefGoogle Scholar
  22. 22.
    Fowler KAB, Locken JA, Duchesne JH, Williamson MR (2002) US for detecting renal calculi with nonenhanced CT as a reference standard. Radiology 222:109–113.PubMedCrossRefGoogle Scholar
  23. 23.
    Tublin ME, Dodd GD, Verdile VP (1994). Acute renal colic: diagnosis with duplex Doppler US. Radiology 193:697–701.PubMedCrossRefGoogle Scholar
  24. 24.
    Burge HJ, Middleton WD, McClennan BL, Hildebolt CF (1991) Ureteral jets in healthy subjects and in patients with unilateral ureteral calculi: comparison with color Doppler US. Radiology 180:437–442.PubMedCrossRefGoogle Scholar
  25. 25.
    Eisner BH, McQuaid JW, Hyams E, Matlaga BR (2011) Nephrolithiasis: what surgeons need to know. AJR Am J Roentgenol 196:1274–1278.PubMedCrossRefGoogle Scholar
  26. 26.
    E-Sabih D, Khan AN, Craig M, Worrall JA (2004) Sonographic mimics of renal calculi. J Ultrasond Med 23:1361–1367.Google Scholar
  27. 27.
    Ray AA, Ghiculete D, Pace KT, Honey RJ (2010) Limitations to ultrasound in the detection and measurement of urinary tract calculi. Urology 76:295–300.PubMedCrossRefGoogle Scholar
  28. 28.
    Thoeny HC, Kessler TM, Simon-Zoula S et al (2008) Renal oxygenation changes during acute unilateral ureteral obstruction: assessment with blood oxygen level-dependent MR imaging—initial experience. Radiology 247:754–761.PubMedCrossRefGoogle Scholar
  29. 29.
    Thoeny HC, Binser T, Roth B et al (2009) Noninvasive assessment of acute ureteral obstruction with diffusion-weighted MR imaging: a prospective study. Radiology 252:721–728.PubMedCrossRefGoogle Scholar
  30. 30.
    Shokeir AA, El-Diasty T, Eassa W et al (2004). Diagnosis of ureteral obstruction in patients with compromised renal function: the role of noninvasive imaging modalities. J Urol 171:2303–2306.PubMedCrossRefGoogle Scholar
  31. 31.
    Shokeir AA, El-Diasty T, Eassa W et al (2004). Diagnosis of noncalcareous hydronephrosis: role of magnetic resonance urography and noncontrast computed tomography. Urology 63:225–229.PubMedCrossRefGoogle Scholar
  32. 32.
    El-Ghar MEA, Shokheir AA, El-Diasty T et al (2004) Contrast enhanced spiral computerized tomography in patients with chronic obstructive uropathy and normal serum creatinine: a single session for anatomical and functional assessment. J Urol 172:985–988.PubMedCrossRefGoogle Scholar
  33. 33.
    Zielonko J, Studniarek M, Markuszewski M (2003) MR Urography of obstructive uropathy: diagnostic value of the method in selected clinical groups. Eur Radiol 13:802–809.PubMedGoogle Scholar
  34. 34.
    Zagoria RJ, Khatod EG, Chen MYM (2001) Abdominal radiography after CT reveals urinary calculi: a method to predict usefulness of abdominal radiography on the basis of size and CT attenuation of calculi. AJR Am J Roentgenol 176:1117–1122.PubMedCrossRefGoogle Scholar
  35. 35.
    Assi Z, Platt JF, Francis IR et al (2000) Sensitivity of CT scout radiography and abdominal radiography for revealing ureteral calculi on helical CT: implications for radiologic follow-up. AJR Am J Roentgenol 175:333–337.PubMedCrossRefGoogle Scholar
  36. 36.
    Rubenstein JN, Schaeffer AJ (2003) Managing complicated urinary tract infections. The urologic view. Infect Dis Clin N Am 17:333–351.CrossRefGoogle Scholar
  37. 37.
    Dacher J, Pfister C, Monroc M et al (1996) Power Doppler sonographic pattern of acute pyelonephritis in children: comparison with CT. AJR Am J Roentgenol 166:1451–1455.PubMedCrossRefGoogle Scholar
  38. 38.
    Majd M, Nussbaum Blask AR, Markle BM et al (2001) Acute pyelonephritis: comparison with Tc99m-DMSA SPECT, spiral CT, MR imaging, and power Doppler US in an experimental pig model. Radiology 218:101–108.PubMedCrossRefGoogle Scholar
  39. 39.
    Wiseman AC (2009) Polyomavirus nephropathy: a current perspective and clinical considerations. Am J Kidney Dis 54:131–142.PubMedCrossRefGoogle Scholar
  40. 40.
    Pearle MS, Pierce HL, Miller GL et al (1996) Optimal method of urgent decompression of the collecting system for obstruction and infection due to ureteral calculi. J Urol 160:1260–1264.CrossRefGoogle Scholar
  41. 41.
    Yablon CM, Banner MP, Ramchandani P et al (2004) Complications of prostate cancer treatment: spectrum of imaging findings. Radiographics 24:S181–194.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2014

Authors and Affiliations

  • Parvati Ramchandani
    • 1
  • Harriet C. Thoeny
    • 2
  1. 1.Genitourinary RadiologyPerelman School of Medicine at the University of PennsylvaniaPhiladelphiaUSA
  2. 2.Department of Radiology, Neuroradiology, and Nuclear Medicine, Institute of Diagnostic, Interventional, and Pediatric Radiology, InselspitalUniversity of BernBernSwitzerland

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