Radiological Imaging of the Kidney, 1st Edition

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Emilio Quaia (Ed.)

Radiological Imaging
of the Kidney
Foreword by
A. L. Baert
Prof. Emilio Quaia
Università Trieste
Ospedale di Cattinara
Ist. Radiologia
Strada di Fiume 447
34149 Trieste
Italy
[email protected]

ISSN: 0942-5373

ISBN: 978-3-540-87596-3     e-ISBN: 978-3-540-87597-0

DOI: 10.1007/978-3-540-87597-0

Springer Heidelberg Dordrecht London New York

Library of Congress Control Number: 2010933084

© Springer-Verlag Berlin Heidelberg 2011

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To my beloved Lorenza, Benedetta, Diletta, and Brigitta
 Foreword

It is my great pleasure and privilege to introduce another volume, published in our

book series “Medical Radiology–Diagnostic Imaging”, which is devoted to
Radiological Imaging of the kidney. It is edited by E.Quaia, widely known for his
numerous original contributions to urogenital radiology, especially in the area of
ultrasound, computed tomography and the role of ultrasound contrast media in the
diagnostic management of diseases of the urogenital organs.
It covers in depth the complete spectrum of superb imaging modalities which are
actually available to study the normal anatomy and the pathology of the kidney and
upper urinary tract, including the latest technical advances in equipment design.
The clear and informative text, the numerous well-chosen illustrations of superb
technical quality as well as the traditional Springer excellent standards of design and
layout make this outstanding work a reference handbook for all certified general and
urogenital radiologists. Also, radiologists in training will find it very useful for
improving their knowledge and skills. Referring physicians such as urologists and
nephrologists will benefit from it to improve the clinical management of their
patients.
I am greatly indebted to the editor E.Quaia for his efficient and brilliant editorial
work as well as for the judicious choice of the contributing authors, all well-known
and internationally recognised experts in the field, who wrote the 36 excellent indi-
vidual chapters of this outstanding volume.

Leuven Albert L. Baert

vii
 Preface

The aim of this book is to provide a comprehensive analysis of the embryology, nor-
mal anatomy, and of the pathology of the kidney and the upper urinary tract (renal
pelvis and upper ureter) according to the modern diagnostic imaging techniques. The
opportunity provided to me by professor Albert Baert represents a wonderful occa-
sion to present an up-to-date resume of what is possible to obtain nowadays by imag-
ing in the evaluation of the normal and pathologic kidney.
Significant technical improvements have allowed the use of radiological tech-
niques to play a growing role in the imaging of renal diseases. Several new imaging
techniques and new technical improvements of the preexisting imaging techniques
have been introduced in the recent years. Contrast-enhanced ultrasound is now con-
sidered a well-established imaging technique in the analysis of renal perfusion and
tumors. Multidetector computed tomography (CT) is able to provide high spatial res-
olution images of the kidneys and renal arterial vessels (CT angiography) and urinary
tract (CT urography). Magnetic resonance imaging (MRI) is now able to provide high
signal-to-noise ratio and higher spatial and/or temporal resolution and to display both
morphological information on renal parenchyma and vessels and functional data,
such as perfusion, filtration, diffusion, or oxygenation. Molecular imaging techniques
have recently been applied in the assessment of renal tumors and parenchymal perfu-
sion. All these imaging modalities have now reached an extremely high level of accu-
racy in detecting renal abnormalities. This book also provides a complete insight in all
these diagnostic fields with the aid of high-quality images obtained with ­state-of-the-art
equipments, as well as by figures showing macroscopic and microscopic specimens
to obtain an effective radiologic-pathologic correlation with diagnostic images.
Each chapter has been written by well-recognized experts in the field, and the
principal effort of the editor was to provide excellent iconography and literature revi-
sion, besides text quality. This book is principally intended for the radiology com-
munity, from the resident to the expert radiologists, even though clinicians and
academic persons could also find it useful for their daily clinical practice.
The imaging archive of the radiology department of Trieste, presenting a complete
iconography of all renal pathologies collected through several years of intense clinical
activity and research in this field, served as a gold mine for the preparation of the book.
My sincere gratitude to professor Baert and to Miss Ursula Davis and Daniela
Brandt from Springer for their continuous support and belief in this work. A note of
thanks also to other staff of Springer for the editorial work.

Trieste Emilio Quaia

ix
 Contents

Part I Embryology and Anatomy

1 Embryology of the Kidney . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Marina Zweyer

2 Normal Radiological Anatomy

and Anatomical Variants of the Kidney . . . . . . . . . . . . . . . . . . . . . . . . . 17
Emilio Quaia, Paola Martingano, Marco Cavallaro,
and Roberta Zappetti

3 Normal Radiological Anatomy of the Retroperitoneum . . . . . . . . . . . 79

Emilio Quaia

Part II Imaging and Interventional Modalities

4 Ultrasound of the Kidney . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87

Emilio Quaia

5 Computed Tomography. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129

5.1 General Concepts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Emilio Quaia, Paola Martingano, and Marco Cavallaro
5.2 Multidetector CT Urography and CT Angiography . . . . . . . . . . . . . 160
Roberto Pozzi Mucelli, Giulia Zamboni,
Livia Bernardin, and Alberto Contro

6 Magnetic Resonance Imaging of the Kidney . . . . . . . . . . . . . . . . . . . . . 179

Maria Assunta Cova, Marco Cavallaro, Paola Martingano,
and Maja Ukmar

7 Renal Angiography and Vascular Interventional Radiology . . . . . . . . 197

Fabio Pozzi-Mucelli and Andrea Pellegrin

8 Nuclear Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229

Egesta Lopci and Stefano Fanti

xi
xii Contents

9 The Role of Kidney Biopsy in the Diagnosis

of Renal Disease and Renal Masses . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
Michele Carraro and Fulvio Stacul

10 Nonvascular Interventional Radiology Procedures . . . . . . . . . . . . . . . 271

Raul N. Uppot

Part III Non-Tumoral Pathology

11 Congenital and Development Disorders of the Kidney . . . . . . . . . . . . 291

Veronica Donoghue

12 Renal Cystic Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311

Kyongtae T. Bae, Alessandro Furlan, and Fadi M. El-Merhi

13 Renal Parenchymal and Inflammatory Diseases . . . . . . . . . . . . . . . . . . 339

Emilio Quaia

14 Obstructive Uropathy, Pyonephrosis,

and Reflux Nephropathy in Adults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 357
Emilio Quaia, Paola Martingano, and Marco Cavallaro

15 Nephrocalcinosis and Nephrolithiasis . . . . . . . . . . . . . . . . . . . . . . . . . . 395

Siân Phillips and Gareth R. Tudor

16 Acute Renal Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 417

Alfredo Blandino, Silvio Mazziotti, Fabio Minutoli,
Giorgio Ascenti, and Michele Gaeta

17 Chronic Renal Infections and Renal Fungal Infections . . . . . . . . . . . . 445

Emilio Quaia, Leonardo Giarraputo, Paola Martingano,
and Marco Cavallaro

18 Renal Vascular Abnormalities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 475

Therese M. Weber and Mark E. Lockhart

19 Imaging of Renal Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 487

Stuart E. Mirvis

Part IV Tumoral Pathology

20 Benign Solid Renal Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 509

Emilio Quaia

21 Renal Cell Carcinoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 543

Nagaraj-Setty Holalkere, Daichi Hayashi, and Ali Guermazi

22 Rare and Secondary Tumors of the Kidney

and Renal Pseudotumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 573
Annelies Rappaport and Raymond H. Oyen
Contents xiii

23 Radiofrequency Ablation and Cryoablation

for Renal Cell Carcinoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 595
Andrew Hines-Peralta and S. Nahum Goldberg

24 Upper Urinary Tract Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 605

Emilio Quaia and Paola Martingano

25 Renal Lymphoma and Renal Sarcoma . . . . . . . . . . . . . . . . . . . . . . . . . 631

Annelies Rappaport and Raymond H. Oyen

26 Cystic Renal Masses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 645

Olivier Hélénon, J.M. Correas, S. Merran, E. Dekeyser,
and A. Vieillefond

Part V Special Topics

27 The Pediatric Kidney . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 675

Michael Riccabona

28 The Kidney in the Elderly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 715

Emilio Quaia and Marco Cavallaro

29 Renal Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 745

Emilio Quaia

30 Renal Transplantation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 763

Nicolas Grenier

31 Imaging of Dialysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 793

Emilio Quaia and Salvatore Sammartano

32 Imaging of the Postoperative Kidney . . . . . . . . . . . . . . . . . . . . . . . . . . . 811

Emilio Quaia

33 Contrast Media-Induced Nephropathy

and Nephrogenic Systemic Fibrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 831
Fulvio Stacul

34 Functional Imaging of the Kidney . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 845

Nicolas Grenier

35 Molecular Imaging and Tumoural Antigen Targeting . . . . . . . . . . . . . 871

Cristina Nanni and Stefano Fanti

36 Research Perspectives and Future Trends in Renal Imaging . . . . . . . 879

Nicolas Grenier

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 897
 Part
I
Embryology and Anatomy