Presentation
Monitoring of non obstructive renal calculi. Microscopic hematuria.
Patient Data
Multiple bilateral rounded water-attenuation structures showing no opacification during the delayed urographic images indicating renal sinus cysts (perirenal cysts).
Small linear cortical lesion seen in the posterior lower pole of the left kidney which is filled with contrast in the excretory phase suggestive of calyceal diverticulum.
Non obstructive calculus is noted in the lower pole calyx of the left kidney. A tiny calculus is noted in the right kidney. No radiopaque calculi are seen in the ureters and the moderately filled urinary bladder. No hydroureteronephrosis or perinephric fat stranding.
Patent and well-opacified bilateral renal arteries. Renal veins are also patent.
A simple cortical cyst is noted in the lower pole of left kidney.
Case Discussion
Peripelvic renal sinus cysts can mimic hydronephrosis on ultrasound and non-contrast CT. CT urography can differentiate hydronephrosis from cysts. The excretory phase demonstrates non-filling of renal sinus cysts which can narrow or the distort the non-dilated collecting system.
Calyceal diverticulum is another condition which can be diagnosed by CT urography. In the excretory phase the diverticulum will fill with contrast medium due to its communication with the collecting system.
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