Renal Cell Carcinoma CT Scan

http://info.med.yale.edu/surgery/anatomy/radiology/renal_ca_content.php

SLIDE 1
Renal Cell Carcinoma
- Why does the right kidney look like a donut with bright stuff in the donut hole?
– the kidney treats venous contrast like a waste product and concentrates it in the urine

- Why is the tumor in the left kidney duller than the rest of the donut?
– the tumor is hypovascular in relation to the renal parenchyma

- Is this section closer to the transpyrolic, subcostal, or umbilical plane? Why?

– the transpyloric: the superior mesenteric artery branches off the aorta; the pancreas is present; ribs are present; renal arteries (subcostal plane) ureters (which whould be bright with contrast, are absent)

CT reconstruction of the kidneys and renal arteries and 3-D reconstruction of kidneys and SMA vasculature

http://info.med.yale.edu/surgery/anatomy/radiology/CT_kidney_content.php

TOPICS

SLIDE 1
Goals
1. Be able to identify the renal vessels, aorta and ureters as these structures are rotated in 3-D
2. Be able to explain the relative position of important nearby structures that are not shown such as the 12th rib and IVC

SLIDE 2
- CT reconstruction of the kidneys and renal arteries
- Rib 12 is colored blue, the abdominal aorta is pink and the renal arteries are red
- Transpyloric plane
- Subcostal plane

SLIDE 3
[...]

SLIDE 4
3-D reconstruction of kidneys and SMA vasculature
- aorta
- left renal artery
- left renal vein
- right renal artery
- left ureter
(and questions)
- right ureter
- SMA (superior mesenteric artery)
- IMA (inferior mesenteric artery)

SLIDE 5
- lumbar segmental arteries
(question)

SUMMARY
1. The renal vessels are at the subcostal plane
2. The left renal artery is posterior to the left renal vein
3. The kidneys are posterior to the aorta and IVC, so the vessels course posteriorly from the midline to reach their targets

Click on this link to view the JPG image –> Abdominal cross section anatomy at L5

Terms:

Left term: umbilical impression, ileum, rectus abdominis muscle, ileocecal junction, cecum, internal oblique muscle, external oblique muscle, psoas major muscle, iliacus muscle, body of L5 vertebra, lumbar cistern of subarachnoid space

Right term: common iliac arteries, ureter, ileum, descending colon, transversus abdominis muscle, lumbar plexus (ventral rami of L2-L4 becoming femoral and obturator nerves and L4 part of lumbosacral trunk), iliac crest, erector spinae muscle

Source:
Netter Anatomy

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L4 abdominal cross section anatomy

Terms:
Left side:
Round ligament (ligamentum teres) of liver, transverse colon, branches of inferior epigastric vesselss, rectus sheath, transversus abdomini aponeurosis, external oblique aponeurosis, mesentery of small intestine, superior mesenteric vessels, small intestine (ileum), lymph node, ascending colon, right paracolic gutter, tendon of origin of transversus abdomini muscle, iliohypogastric nerve, ilioinguinal nerve, layers of thoracolumbar fascia (combined, middle, posterior), right colic vessels and branches, right genitofemoral nerve, transverse process of L4 vertebra, inferior vena cava, anterior longitudinal ligament, ligamentum flavum, abdominal aorta, spinous process of L3 vertebra, supraspinous ligament

Right side:
Linea alba, rectus abdominis muscle, omental appendices, greater omentum, parietal peritoneum, transversalis fascia, transversus abdominis muscle, internal oblique muscle, external oblique muscle, small intestine (jejunum), descending colon, left paracolic gutter, left ureter, quadratus lumborum muscle, latissimus dorsi muscle, testicular (ovarian) vessels, psoas minor muscle, parietal peritoneum, psoas major muscle, inferior mesenteric and 1st sigmoid vessels, left sympathetic trunk, left lumbar plexus ventral rami of L2,L3 spinal nerves, erector spinae muscle, superior articular process of L4 vertebra, Intercostal disc between L3 and L4 vertebrae, intermesenteric (aortic) plexus

Source:
Netter Anatomy