Learning objectives
To review the anatomy of the renal sinus and its contents.
To make an approach to the various imaging modality techniques for the evaluation of this area.
To illustrate through imaging cases the radiological findings of the most common and uncommon pathologies that affect the renal sinus.
Background
The renal sinus is a cavity in the epicentre of the kidney communicated to the perinephric space and bordered laterally by the renal parenchyma.
It has different kind of constituents (Fig.
1):
Excretory system (pelvis,
major and minor calyces of the collecting system).
Vessels (major branches of the renal artery and vein).
Nerve fibers of the autonomic nervous system.
Lymphatic channels.
The rest is filled with adipose tissue (main component) and varying quantities of fibrous tissue.
Therefore,
various pathologic conditions can occur.
The spectrum of...
Findings and procedure details
IMAGING PROTOCOLS:
The modality techniques for imaging acquisition and evaluation of the renal sinus can varyfrom:
US.Basic distinction of cystic from solid space-occupying lesions.
Doppler: Study of renal vascular lesions and vascularization of the kidney.
Multidetector CT. Most sensitive,
efficient and fastest technique.
It provides high temporal and spatial resolution.
Multiplanar reconstructions.
Non-enhanced CT (NECT): Detection of calcium and blood.
It is used as a baseline in order to check the contrast enhancement.
Corticomedullary phase (35-40’’): Establishes the relation with vascular structures and the degree...
Conclusion
There are several conditions that affect the renal sinus.
There is an enormous variety of lesions,
with different histological and imaging features,
that can have either an origin or affect secondary the renal sinus.
The renal sinus is sometimes an unknown and forgotten anatomical space for the radiologists,
but it is important to take into account and to know the radiological patterns and manifestations involving this area of the kidney in order to make an accurate differential diagnose.
References
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IgG4-related inflammatory pseudotumor of the kidney mimicking renal cell carcinoma: A case report.
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