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Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
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Imaging Studies V: Intravenous Urography and Retrograde Pyelography01:22

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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...
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The lower urinary system consists of the urinary bladder and urethra, which are essential in storing and expelling urine from the body. Together with the internal and external sphincters, these structures work together to regulate urination effectively.Anatomy of the BladderThe urinary bladder is a muscular, stretchable organ behind the pubic bone and in front of the rectum. In females, the bladder is positioned anterior to the vagina and inferior to the uterus, while in males, it is located...
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Imaging Studies I: Kidney, Ureter, and Bladder Studies01:28

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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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The nursing assessment of the genitourinary (GU) system involves a systematic inspection and palpation to identify abnormalities in the kidneys, bladder, and surrounding structures.InspectionMouth: Inspect for signs of kidney dysfunction, such as stomatitis (inflammation of the mouth) and ammonia breath, which may occur in advanced kidney disease due to the buildup of urea, breaking down into ammonia.Skin: Check for pallor, which could indicate anemia caused by kidney disease. Look for...
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Imaging Studies IV: Magnetic Resonance Imaging01:27

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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,...
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Bladder paragangliomas: a pictorial review.

Samuel J Withey1, Dimitra Christodoulou2, Davide Prezzi2

  • 1Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK. samuel.withey@nhs.net.

Abdominal Radiology (New York)
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Summary

Bladder paragangliomas (bPGL) are rare tumors. Advanced imaging like MRI and PET/CT are crucial for diagnosis, surgical planning, and treatment of bPGL, with genetic screening recommended for patients.

Keywords:
BladderCTMRIPET/CTParagangliomaUltrasound

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Area of Science:

  • Urology
  • Oncology
  • Radiology

Background:

  • Bladder paragangliomas (bPGL) are rare neuroendocrine tumors originating from sympathetic paraganglia in the bladder wall.
  • They can be submucosal, intramural, or subserosal, impacting visibility during cystoscopy.
  • Tumor size and complexity vary, with larger bPGLs exhibiting neovascularity and necrosis.

Purpose of the Study:

  • To review the diagnostic imaging modalities for bladder paragangliomas.
  • To discuss the role of imaging in surgical planning and treatment selection for bPGL.
  • To highlight the importance of genetic screening and lifelong surveillance in bPGL patients.

Main Methods:

  • Review of imaging characteristics of bPGL on ultrasound, MRI, CT, and nuclear medicine.
  • Discussion of the utility of 68Ga-DOTATATE PET/CT and 123I-mIBG SPECT/CT in diagnosis and treatment planning.
  • Emphasis on the genetic basis of bPGL and recommended screening protocols.

Main Results:

  • Ultrasound shows increased color Doppler signal; MRI offers superior soft tissue resolution for localization.
  • Restricted diffusion and avid contrast enhancement on MRI help differentiate bPGL from leiomyomas.
  • Nuclear medicine, particularly 68Ga-DOTATATE PET/CT, is highly specific for detecting bPGL and metastases.

Conclusions:

  • Imaging is essential for accurate diagnosis, surgical planning, and treatment of bladder paragangliomas.
  • Advanced imaging techniques like PET/CT are vital for assessing treatment suitability, especially for advanced disease.
  • Germline mutations are common, necessitating lifelong screening for associated conditions.