Kidneys Imaging Table (Organ-Specific Section)

 

Modality Imaging Type Description / Use
US Renal Ultrasound First-line imaging for obstruction (hydronephrosis), cysts, masses, infection (pyelonephritis), transplant evaluation
US Doppler Renal Ultrasound Evaluation of renal artery stenosis, renal vein thrombosis, transplant perfusion
CT CT Abdomen and Pelvis Without Contrast (Stone Protocol) Gold standard for renal stone detection
CT CT Abdomen and Pelvis With Contrast Evaluation of renal masses (solid vs cystic), infection (abscess), trauma, infarcts
CT CT Urogram Detailed evaluation of urothelial tumors, hematuria, upper tract obstruction
CT CT Angiography (Renal Arteries) Non-invasive imaging of renal artery stenosis, aneurysms, infarction, trauma
MRI MRI Abdomen (Renal Focus) Problem-solving tool for complex cystic lesions, renal masses; used when CT contraindicated
MRI MR Angiography (Renal Arteries) Alternative to CTA for renal artery stenosis evaluation (especially in patients with contrast allergy or renal insufficiency)
Fluoroscopy Retrograde Pyelography Direct contrast injection into renal collecting system via cystoscopy; detects stones, strictures, masses
NM MAG3 Renal Scan (with or without Lasix) Functional imaging for obstruction, differential renal function
NM DTPA Renal Scan Measures glomerular filtration rate (GFR); useful for transplant function
NM DMSA Renal Scan Static imaging for cortical scarring, differential function (especially in pediatrics)
Angiography Digital Subtraction Angiography (DSA) Renal Arteries Gold standard for diagnosis and endovascular treatment of renal artery stenosis, aneurysms, embolization for trauma/bleeding

Clinical Pearls — Kidneys Imaging

 

Clinical Scenario Best Imaging First-Line
Suspected Nephrolithiasis (Kidney Stones) CT Abdomen and Pelvis Without Contrast (Stone Protocol)
Renal Mass Evaluation Renal Ultrasound first (simple vs complex); CT Abdomen with Contrast for solid tumors
Complex Cyst Evaluation MRI Abdomen (Bosniak classification for cystic lesions)
Hematuria Workup CT Urogram
Suspected Pyelonephritis (Complicated UTI) Renal Ultrasound initially; CT with Contrast if complicated
Trauma to the Kidney CT Abdomen and Pelvis With Contrast (renal trauma protocol)
Renal Artery Stenosis (Hypertension) Doppler Renal Ultrasound first; CTA or MRA if unclear
Renal Infarction CT Angiography (CTA) of Renal Arteries
Post-Transplant Kidney Evaluation Renal Ultrasound with Doppler; DTPA Renal Scan for function
Evaluation of Differential Renal Function MAG3 or DMSA Renal Scintigraphy

Related Links

Google ImagesGoogleYouTubeWikipediaRadiopediaRadiographics
StatDx
UpToDateChatGPT