Ekstrarenal pelvis

Özet

Ekstrarenal pelvis, renal sinüs yağ dokusunun dışında daha belirgin görünen, böbreğin benign anatomik varyantıdır. Kontrastsız BT taşların saptanmasını sağlar; BT ürogramın ekskretuar fazında kaliksler ve pelvis iyotlu idrarla dolar. Kontrastsız BT, üreter taşını ve taşla ilişkili obstrüksiyonun ikincil bulgularını değerlendirmeye olanak verir. Ekstrarenal pelvis ve üreter dilatasyonu obstrüksiyon olmadan birlikte görülebilir; bu nedenle pelvis dolgunluğu tek başına obstrüksiyonu kanıtlamaz.

Faz ve pencere

Kontrastsız tanısal

BT ürogramda ekstrarenal pelvis ve üreter dilatasyonu görülebilir; bildirilen olguda obstrüksiyon veya ikincil neden saptanmamıştır.

BT bulguları

• BT ürogramda ekstrarenal pelvis görünümü, üreter dilatasyonu ile birlikte görülebilir.
• Üreteropelvik bileşke obstrüksiyonunda pelvikaliksiyel sistem değişen derecelerde genişleyebilir.
• Ekstrarenal pelvis ve üreter dilatasyonu, obstrüksiyon olmadan birlikte görülebilir.
• Üreteropelvik bileşke obstrüksiyonunun görüntüleme değerlendirmesinde renal korteksin kalınlığı ve mimarisi incelenir.
• Üreteropelvik bileşke obstrüksiyonunda pelvikaliksiyel sistem genişleyebilirken üreter normal kalibrede olabilir.
• Bir otopsi serisinde sağ ve sol böbrekler arasında toplayıcı sistem morfolojisi bakımından anlamlı fark saptanmamıştır.
• Perinefrik yağ çizgilenmesi, üreter taşına bağlı obstrüksiyonun BT’de değerlendirilebilen ikincil bulgularındandır; tek başına ekstrarenal pelvis tanısını desteklediği kaynaklarda gösterilmemiştir.

Normalde

Bir olgu bildiriminde BT ürogramda ekstrarenal pelvis ve üreter dilatasyonu, obstrüksiyon veya ikincil neden olmaksızın izlenmiştir. Üreter dilatasyonu obstrüksiyon olmadan da görülebilir; bir olgu bildiriminde dilate ekstrarenal pelvis ve üreterlere karşın obstrüksiyon veya ikincil neden saptanmamıştır.

Ayırıcı tanı

Hidronefrozda pelvikaliksiyel sistem değişen derecelerde genişleyebilir; üreteropelvik bileşke obstrüksiyonunda üreter normal kalibrede olabilir.

Üreteropelvik bileşke obstrüksiyonunda pelvikaliksiyel sistem genişleyebilirken üreter normal kalibrede olabilir.

Tuzaklar

• Pelvisin tek başına geniş görünmesi hidronefroz tanısı koydurmaz; kaliks ve üreter çapı da değerlendirilmelidir.
• Kontrastsız BT taş saptamaya yardımcı olur; kaliks ve pelvisin opaklaşması ise BT ürogramın ekskretuar fazında değerlendirilir.
• Ekstrarenal pelvis görünümüne üreter dilatasyonu eşlik edebilir ve bu birliktelik tek başına obstrüksiyonu göstermez.
• Ekstrarenal pelvis görünümüne üreter dilatasyonu eşlik edebilir; bir olgu bildiriminde bu birliktelikte obstrüksiyon veya ikincil neden saptanmamıştır.

Kendini dene

1. Bir olgu bildiriminde BT ürogramda ekstrarenal pelvis ve üreterler dilate görülmüş; obstrüksiyon veya ikincil neden saptanmamıştır. Bu olguda hangi sonuç bildirilmiştir?

   • Obstrüksiyonsuz, ikincil nedeni gösterilemeyen dilatasyon
   • Üreter taşıyla kanıtlanmış akut obstrüksiyon
   • Üreteropelvik bileşke darlığı
   • Parapelvik kist
   Cevabı göster

   Obstrüksiyonsuz, ikincil nedeni gösterilemeyen dilatasyon. Olgu bildiriminde BT ürogram ekstrarenal pelvis ve üreter dilatasyonunu göstermiş, obstrüksiyon veya ikincil neden saptanmamıştır.

2. Kontrastsız BT'de üreter taşı saptanan hastada hangi ek değerlendirme yapılabilir?

   • Taşla ilişkili obstrüksiyonun ikincil bulgularını değerlendirmek
   • Renal pelvisin ekskretuar fazda opaklaşmasını doğrudan ölçmek
   • Üreter taşının kimyasal bileşimini her durumda belirlemek
   • Obstrüksiyonu yalnız taşın varlığıyla kesinleştirmek
   Cevabı göster

   Taşla ilişkili obstrüksiyonun ikincil bulgularını değerlendirmek. Kontrastsız BT üreter içindeki taşı gösterir ve taşla ilişkili obstrüksiyonun ikincil bulgularının değerlendirilmesine olanak verir.

Kaynaklar

Bu sayfadaki 31 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 25 cümle bu karşılaştırmada düzeltildi (2026-10-09).

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Eğitim amaçlıdır; hasta başında tanı ve tedavi kararının yerine geçmez, tıbbi tavsiye değildir. Metinler yapay zekâ desteğiyle yazıldı ve otomatik bir adımda kaynak alıntılarıyla karşılaştırıldı; bu bir tıbbi doğrulama değildir ve içerik uzman radyolog incelemesinden geçmedi. Klinik kararlarda güncel kılavuzları, kurum protokollerini ve radyoloji raporunu esas alın.