Renal Tubular Ectasia

As with EU, renal tubular ectasia produces easily visualized linear areas of high attenuation in the renal pyramids on CTU. These dilated collecting tubules (which may be associated with nephrocalcinosis that can be visualized on noncontrast CT images) are best seen on wide-window images. Renal tubular ectasia may be completely missed if only standard soft tissue windowing is employed (Fig. 8).

Figure 5 Infiltrative transitional cell carcinoma. (A) There is marked circumferential ureteral wall thickening (arrow) in the mid-left ureter produced by an extensive transitional cell carcinoma. Note that the ureteral lumen is not obstructed or narrowed and its contour appears smooth. (B) In fact, the ureter appears normal both in diameter and in contour on the coronal excretory-phase, volume-rendered reconstruction. It is likely that no abnormality would have been detected on EU as well. Abbreviation: EU, excretory urography.

Figure 5 Infiltrative transitional cell carcinoma. (A) There is marked circumferential ureteral wall thickening (arrow) in the mid-left ureter produced by an extensive transitional cell carcinoma. Note that the ureteral lumen is not obstructed or narrowed and its contour appears smooth. (B) In fact, the ureter appears normal both in diameter and in contour on the coronal excretory-phase, volume-rendered reconstruction. It is likely that no abnormality would have been detected on EU as well. Abbreviation: EU, excretory urography.

Ectasia Renal

Figure 6 Transitional cell carcinoma. (A) Nearly circumferential left ureteral wall thickening is noted at the level of the lower pole of the left kidney (arrow). (B) The wall thickening continues all the way caudal to the pelvic inlet (arrow). (C) Left posterior oblique coronal volume-rendered reconstruction shows that the left ureter is normal in caliber throughout. The diffuse nature of this extensive transitional cell carcinoma cannot be identified. The extent of the cancer would have not been accurately identified on EU. In fact, the cancer would likely have been missed altogether. Abbreviation: EU, excretory urography.

Figure 6 Transitional cell carcinoma. (A) Nearly circumferential left ureteral wall thickening is noted at the level of the lower pole of the left kidney (arrow). (B) The wall thickening continues all the way caudal to the pelvic inlet (arrow). (C) Left posterior oblique coronal volume-rendered reconstruction shows that the left ureter is normal in caliber throughout. The diffuse nature of this extensive transitional cell carcinoma cannot be identified. The extent of the cancer would have not been accurately identified on EU. In fact, the cancer would likely have been missed altogether. Abbreviation: EU, excretory urography.

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