PMC4298278_01
Abdominal US - simple renal cyst in the mid-portion of the left kidney.
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Ultrasound examination (Figure 1) showed a thin-walled cyst filled with non-echogenic fluid, 23 mm in diameter, in the central part of the left kidney.
Renal scintigraphy revealed area without radiomarker accumulation in the excretory phase, but with accumulation in the late phase.
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Scintigraphy (99mTC-EC) was performed two months after hospitalization in order to precisely assess postinflammatory lesions in renal parenchyma (Figure 2), demonstrating lack of accumulation of the radiomarker in the center of the left kidney in the parenchymal phase, followed by its accumulation in the late phase.
Conventional X-ray urography revealed displacement of the collecting system in the central part, without urinary flow obstruction.
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Conventional X-ray urography was performed one month later in order to verify these findings (Figure 3), which demonstrated modeling of central portion of pelvicalyceal system without urinary obstruction.
Multiphase CT urography (phases: unenhanced, parenchymal and delayed 15 min. after IV contrast injection) (A-C). Examination revealed contrast filling of the cyst - delayed phase (C) demonstrates level of the contrast and increased enhancement of fluid within the cyst, confirming communication between the renal cyst and the collecting system.
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Due to some discrepancies between results of previous studies, the girl was referred for multi-phase computed tomography urography (phases: native, parenchymal and late - 15 minutes after administration of contrast medium) (Figure 4A-4C).
Abdominal x-ray, performed 1.5 hours after CT urography, revealed contrast retention within the cyst.
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CT (Figure 5) showed retention of contrast agent within the cyst. CT image indicated presence of large calyceal diverticulum.