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Related Concept Videos

Imaging Studies VII: Vascular Imaging01:19

Imaging Studies VII: Vascular Imaging

DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
Imaging Studies V: Intravenous Urography and Retrograde Pyelography01:22

Imaging Studies V: Intravenous Urography and Retrograde Pyelography

IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
Imaging Studies IV: Magnetic Resonance Imaging01:27

Imaging Studies IV: Magnetic Resonance Imaging

Introduction:Magnetic Resonance Imaging, or MRI, can include a specialized imaging technique of the urinary system known as Magnetic Resonance Urography (MRU). This radiation-free technique uses strong magnetic fields and radio waves to produce detailed images with the help of a computer. MRU is particularly effective for visualizing fluid-filled structures like the kidneys, ureters, and bladder.Applications of MRI in the Genitourinary SystemKidneys and Ureters: MRI detects tumors, cysts,...
Imaging Studies III: Computed Tomography01:27

Imaging Studies III: Computed Tomography

DefinitionComputed Tomography (CT) of the genitourinary (GU) tract is a non-invasive imaging modality that utilizes X-rays and computer processing to generate detailed cross-sectional images of the urinary system, encompassing the kidneys, ureters, bladder, and adjacent structures such as the adrenal glands.PurposeCT scans of the GU tract serve several diagnostic and therapeutic purposes, including:Diagnosis of Urinary Tract Diseases: Detects kidney stones, tumors, cysts, and congenital...
Imaging Studies II: Ultrasonography01:24

Imaging Studies II: Ultrasonography

IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
Imaging Studies I: Kidney, Ureter, and Bladder Studies01:28

Imaging Studies I: Kidney, Ureter, and Bladder Studies

Kidney, Ureter, and Bladder (KUB) StudiesKidney, Ureter, and Bladder (KUB) studies are standard diagnostic imaging procedures used to assess the anatomy of the urinary system. They are commonly utilized for patients experiencing abdominal pain or urinary symptoms. By using a simple X-ray of the abdomen, KUB studies can reveal structural and pathological abnormalities within the kidneys, ureters, and bladder. These studies are particularly valuable in diagnosing kidney stones, urinary...

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Updated: May 20, 2026

In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses
09:31

In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses

Published on: March 30, 2015

Does imaging modality used for percutaneous renal access make a difference? A matched case analysis.

Sero Andonian1, Cesare M Scoffone, Michael K Louie

  • 1Department of Urology, McGill University Health Centre, Montreal, Canada.

Journal of Endourology
|July 28, 2012
PubMed
Summary

Fluoroscopic guidance for percutaneous nephrolithotomy (PCNL) access was linked to more bleeding, but this was due to larger sheath sizes and multiple punctures, not the guidance method itself. Further trials are needed.

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In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses
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Point-of-Care Kidney and Genitourinary Ultrasound in Adults: Image Acquisition
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Point-of-Care Kidney and Genitourinary Ultrasound in Adults: Image Acquisition

Published on: June 21, 2024

Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Nephrolithiasis Management

Background:

  • Percutaneous nephrolithotomy (PCNL) is a key procedure for kidney stone removal.
  • Guidance methods for percutaneous access, primarily ultrasound and fluoroscopy, influence perioperative outcomes.
  • Understanding the comparative safety and efficacy of these guidance techniques is crucial for optimizing patient care.

Purpose of the Study:

  • To evaluate and compare perioperative outcomes between ultrasound-guided and fluoroscopic-guided percutaneous access during PCNL.
  • To identify factors contributing to complications such as hemorrhage and transfusion requirements.

Main Methods:

  • Analysis of a prospectively collected international database (CROES) of 5806 PCNL patients.
  • Stratification of patients into ultrasound-guided (n=453) and fluoroscopic-guided (n=2853) access groups.
  • Comparison of patient characteristics, operative data, and postoperative outcomes, including complication rates, stone-free rates, and hospitalization duration.

Main Results:

  • While overall complication rates were similar, fluoroscopic guidance was associated with significantly higher rates of postoperative hemorrhage (13.1% vs. 6.0%) and transfusions (11.1% vs. 3.8%).
  • Multivariate analysis revealed that larger access sheath sizes (≥ 24F) and multiple renal punctures, not fluoroscopy itself, were independently associated with increased bleeding risk.
  • No significant differences in stone-free rates were observed between the groups, though the ultrasound group had shorter mean hospitalization (3.5 vs. 5.3 days).

Conclusions:

  • Univariate analysis suggested fluoroscopy was linked to higher hemorrhage, but multivariate analysis identified larger access sheath size and multiple punctures as the primary drivers of bleeding.
  • The choice of guidance method (ultrasound vs. fluoroscopy) does not appear to be an independent risk factor for bleeding when sheath size and puncture number are considered.
  • Prospective randomized trials are warranted to definitively clarify the role of imaging guidance in PCNL outcomes.