how to learn basics of urological imaging focusing on kub

3. Imaging modalities
• Conventional X-rays (KUB) (PUT)
• Ultrasonography (US)
• Computed tomography (CT)
• Radionuclide imaging
• Magnetic resonance imaging (MRI)
• Angiography conventional , CT , MRI
• Interventional techniques

4. Plain UT (KUB)
• Simple procedure
• Require adequate patient preparation
Diagnostic values:
• Radioopaqe calculi
• Calcifications
• Gas patterns
• Organomegaly
• Bone abnormalities

5. How to look at an abdominal X-ray
Approach to the film
 Technical assessment (name, date, date of birth, age and sex)
 Establish the projection of the film AP ‘Supine’ or ‘Erect’.
 Look upon X-rays as an extension of history & physical examination.
 In any female of reproductive age check for the LMP
 Only five basic densities are normally present on X-rays:
 Gas black
 Fat dark grey
 Soft tissue/fluid light grey
 Bone/calcification white
 Metal intense white
 In the abdomen the primary structures outlined are:
 The solid organs, such as the liver, kidneys and spleen;
 The hollow organs (i.e. the gastrointestinal tract);
 The bones.

6. Normal abdominal X-ray

7. What will you look for ?
 Bones
 The solid organs (viscera)
 The hollow viscera (gas-containing
gastrointestinal tract)
 Calcified structures
 Urinary stones
 Foreign bodies

8. Bones
 Fractures
Vertebral bodies , pelvis , etc…
 Osteolytic lesions
Metastases , TB
 Osteosclerotic lesions
PCA metastases
 Absence of bones
Spina pefida
 Diastasis
symphysis

9. Fractures

10. Osteolytic lesions
Metastases TB

11. Osteosclerotic lesions
eg in PCA

12. Absence of bones
eg spina bifida

13. Diastasis
(ectopia vesica)

14. The solid organs
 Look for the psoas muscles
 Look for the kidneys
 Look for the liver
 Look for the spleen
 Look for the bladder
 Look for the uterus

15. Psoas shadow

16. Renal shadow

17. UB Shadow

18. The hollow viscera (gas-containing
gastrointestinal tract)
 Look for the stomach
 Look for the small bowel
 Look for the colon

19. Calcified structures
 Aorta
 Pelvic phleboliths
 Splenic artery
 calcified lymph nodes
 Calcified tumour

20. Calcified aorta

21. Pelvic phleboliths

22. Calcified Splenic artery

23. Calcified lymph nodes

24. Urinary stones
 Renal stones
 Ureteric stones
 Bladder stones
 Urethral stons

25. Renal stones

26. Ureteric stones

27. Bladder stones

28. Urethral stons

29. Foreign bodies
 Iatrogenic
Surgical clips , IUDs , IVC filters , JJ
 Accidental
Bullets, swallowed items

30. JJ

31. IUDs

32. IVC filters

33. Intraabdominal Bullets

34. Rectal foreignbody

35. Revision

43. Than
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