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Overflying the Renal Sinus

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OVERFLYING THE RENAL SINUS



Learning Objectives


  1. To describe the anatomical features of the renal sinus and its contents.

  2. To illustrate through imaging cases, the radiological findings of the most common and uncommon renal sinus pathologies.

  3. To make an approach to the various imaging modalities for the evaluation of these conditions.

 


Background


The renal sinus is a cavity in the epicentre of the kidney and has different kind of constituents that include vessels, collecting system, lymphatic channels, nerves, fibrous and adipose tissue. Therefore, various pathologic conditions can occur.

Imaging Findings or Procedure Details


The spectrum of renal sinus lesions can be divided in benign and malign. Alternatively, the abnormalities can be classified in either from the sinus itself or as an extension of other pathologies.

 

Some of these entities are frequently seen in the daily practice, such as renal sinus cysts, lipomatosis, lipomas or urothelial tumors. But there are other atypical pathologies that must be considered, for example, xanthogranulomatous pyelonephritis, arteriovenous communications, IgG4-related pseudotumors, cystic lymphangiomas, trauma injuries, angiomyolipomas, papillary renal cell carcinomas or lymphomas, among others.

 

The modality techniques for imaging acquisition in the renal sinus evaluation can vary from CT, MR or ultrasound to excretory urography and angiography.

 

We will analyse the radiological appearance of these typical and atypical scenarios through a number of different cases seen in the Abdominal Radiology Department of our hospital, Hospital Vall d'Hebron de Barcelona.

 

 

Conclusion


Through this imaging review of the renal sinus pathologies, we expect the readers to understand the radiographic patterns and manifestations involving this area of the kidney in order to make an accurate differential diagnosis.

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