Diagnostic Imaging of the Renal System in Exotic Companion Mammals

Radiographs can be used to easily visualize common types of urinary calculi in all parts of the urinary tract. Positive-contrast excretory urography and cystourethrography are sensitive to diseases within the ureters and urethra, most commonly obstruction. Ultrasound is widely available and noninvasive and can be used to evaluate renal architecture, ureteral dilation, urinary bladder wall disease, and urolithiasis. Computed tomography is increasing in availability and provides a large amount of cross-sectional information quickly and noninvasively. Multiple imaging modalities can be used to estimate or quantify glomerular filtration rate.

[Value of imaging in upper urinary tract tumors]

BACKGROUND

Staging of bladder cancer, hematuria as well as the evaluation of unclear findings of the kidneys and ureters are the most frequent indications for imaging of the upper urinary tract (UUT). Endourological assessment of the UUT is much more invasive compared to imaging of the bladder, raising the question of the optimal imaging technique. Several technical improvements regarding computed tomography (CT) as well as magnetic resonance imaging (MRI) were implemented in recent years.

OBJECTIVES

To compare the efficacy and limitations of the most important imaging techniques regarding the UUT.

MATERIALS AND METHODS

Systematic review of the literature and current German, European, and American guidelines regarding bladder cancer, urothelial carcinoma of the UUT and hematuria.

RESULTS

The CT-based urography has superseded excretory urography and is the first choice for imaging of the UUT. In case of contraindications, MRI is a feasible alternative. In all cases, a urography phase is indispensable.

CONCLUSIONS

Imaging of the UUT has to be used in a reasonable combination together with endourological methods and cytology. Optical coherence tomography, confocal laser endomicroscopy and scientific innovations such as radiomics might improve UUT imaging and differential diagnosis of UUT lesions in the future.