Just remember, no study can identify hydronephrosis or ureteral calculi 100% of the time. LTK= left kidney; RO= right ovary; LO= left ovary). Ultrasound images are effected by speckle noise, hence wavelet based denoising technique is used to reduce speckles. Sonography reveals a large, hypoechoic, inhomogenous mass (10 x 8 cms.) To detect the cyst or stone in an abnormal kidney image, SVM classifier is trained with 75 cyst and 75 stone kidney images and tested with 45 cyst and 63 stone images. This kidney shows a large cortical cyst which has expanded outside the confines of the kidney surface. http://emedicine.medscape.com/article/238798-diagnosis (free article). pathological examination of the affected kidney. Complex renal cysts of this nature are usually an incidental finding and need to be middle third of the right kidney. These specialists treat metabolic diseases. Nutcracker phenomenon is the name given to compression of the left renal vein between the superior mesenteric artery anteriorly and the abdominal aorta posteriorly. The color Doppler ultrasound image shows a resultant double right ureteric jet emanating from duplication of Right image: MR urogram of normal kidneys with distinguishable upper, mid, and lower poles Renal vasculature is highly variable with up to 40 % of kidneys not having the classic… followed up. small in size (atrophic) 3) reduced thickness (thinning) of renal cortex (10mm.) Sonography of this 55 yr. old male patient, who presented with hematuria, reveal bilateral grossly enlarged kidneys (14 to 16 cms. Ectopic, or pelvic kidney – kidney is in an abnormal location, much lower than it should be. system. References: Sonography of junctional parenchyma    (abstract), Ultrasound imaging of hypertrophied column of fibrotic tissue (would be seen as hyperechoic bands). Here ultrasound scan shows sediment containing particulate matter in urinary bladder. in the right renal fossa. excellent). The echogenicity and echotexture of the column of tissue CT imaging is usually helpful in determining the presence of fat within the tumor in AML. There complication of cortical or simple renal cysts. On physical examination, the patient was normotensive, tachycardic, and febrile, and he had mild diffuse abdominal tenderness. Ultrasound images clips pseudotumor caused by an abnormal rotation of the right kidney. The danger of rupture of such renal cysts (exophytic) is greater. more cysts in each kidney, if aged from 30 to 59 yrs. What differentiates this cystic mass from the previously discussed cases of renal cysts is the presence of multiple fine Such renal cysts are called exophytic cysts of the kidney. Here (dromedary humps) margins are well defined and show normal renal vessels on color Doppler ultrasound imaging, = clinically not significant; follow up will show no change in characteristics on ultrasound/ sonography, Perinephric fluid or abscess-ultrasound imaging. A renal ultrasound is sometimes called a kidney ultrasound or sonogram. Images courtesy of Dr. Ravi Kadasne, UAE. on bottom right) shows the mass to be in close relation to the tail of pancreas. This test can help diagnose if there is a problem with your child’s urinary system. This suggests bilateral perinephric abscess. the renal cortex. if the Nutcracker phenomenon is associated with symptoms due to this condition, such as hematuria, pelvic varices, varicocele and Echogenic matter is seen within the renal cortical cyst suggesting either hemorrhage or infective change. Good night doc i did an ultrasound today and it appears that one of my unborn baby kidney is abnormal is that dangerous. The first image shows Unlike an X-ray, ultrasound does not expose your child to radiation. Reference: http://emedicine.medscape.com/article/453831-diagnosis. The other form of XPN is the focal type The color Doppler/ Power Doppler ultrasound images further confirm that the hypoechoic AV fistula as vascular access for hemodialysis. abdominal pain, this condition is called nutcracker syndrome.These ultrasound images of Nutcracker phenomenon are courtesy of Dr. Ravi Kadasne, MD, UAE. the right ureteric openings. The transplanted kidney is seen in the left iliac fossa in these ultrasound images. tumor. kidney. multiple large cysts (more than 2 in each kidney) of sizes varying from 2 to 5 cms. No vessels are seen within the cyst. Blockages in the kidneys 4. Absent or hypoplastic kidney – one kidney is not present or small. The ultrasound and color Doppler images show multiple dilated vessels in the arm which These ultrasound and colour Doppler images show a typical renal injuries may be classified as grade-1 renal trauma. tecting the abnormality in kidney For training the Viola Jones algorithm we have used Kernel 790 ultrasound images. case of nutcracker phenomenon. Color doppler images of the left kidney show normal vascular pattern in the column. The affected kidney shows mild obstructive changes. The central portion is markedly hypoechoic suggestive of necrosis. renal calculi. 28 years experience Family Medicine. Ultrasound images are courtesy of Dr. Ravi Kadasne, M.D., UAE. 9.1 Left image: Intravenous pyelogram demonstrating normal configuration of a left kidney with upper-pole (white arrows), mid-pole (red arrows), and lower-pole (blue arrows) calyces. kidney. Doppler image also shows the non vascular nature of the cyst walls and septae. Main tests. ultrasound images are diagnostic of horseshoe kidney. The hypoechoic masses in the kidney represent renal parenchyma, both CT scan images confirm the large left renal mass with enhancement of the tumour and necrotic central area. in the left kidney. imaging and where needed, MR imaging is also indicated. The pancreatic head is swollen and hypoechoic. References: Trifid renal pelvis- case study. So the first step to help you read the ultrasound image … Both kidneys show renal parenchymal edema evident as early loss of cortico-medullary differentiation with swelling of the renal surgical approach for the patient. kidney disease- ARPKD where I have posted some images of fetal polycystic kidneys. tissue in the junctional parenchyma/ hypertrophied column of Bertin is absolutely normal renal parenchyma and contains renal cortex, pyramids and septa or columns of Bertin. This is a relatively rare form of renal infection One can view ultrasound and Color Doppler videos of this case at: http://ultrasound-videos.blogspot.com/2010/11/unusual-ectopic-fused-kidneys.html, References: Pictorial Download my E book for Amazon Kindle (download free Kindle reader for i Phone or Android), Assorted ultrasound cases- by Joe Antony, MD. both kidneys. With ultrasound, the needle tip (arrow) could be precisely positioned within the rim to biopsy the viable portion of tumor and avoid the adjacent normal hepatocytes or necrotic portions of the lesion. The Bosniak classification describes the various grades of cysts from category-1 (simple renal cysts without septae or Thus this is a duplex right kidney with complete duplication of the collecting system (double right ureters). These ultrasound images and findings are the hallmark of what is called complex renal cysts. It is a diagnostic exam that produces real-time images of the size, shape, and location of the kidney as well as the ureters (thin tubes that carry urine from the kidney to the bladder) and bladder. A solitary cyst is seen in the right lobe of liver. Left kidney- upper pole cortical cyst with echogenic contents suggesting hemorrhage. These ultrasound images are clearly suggestive of fatty tissue within the renal sinus- the condition being called renal sinus lipomatosis. urinary bladder. Both kidneys are literally studded with these minute cystic lesions (more than 20 in each kidney) with many of them showing the presence of milk of calcium. -hemorrhagic fluid (perinephric hematoma). normal renal tissue or morphology seen suggesting that this lady has severe renal failure. References: Perinephric fluid or abscess-ultrasound imaging, = a hump or lump bulging from the superior and lateral spect of the kidney, = always affects the left kidney and is due to the spleen compressing upon the left kidney, = name dromedary hump is derived from the hump seen in dromedary camels, = D/d: must be distinguished from renal masses. The above ultrasound images show echogenic tissue in the lower part of the left kidney within the renal sinus. diverticulum /calyceal cyst of the right kidney. c) 4 cysts in each kidney if aged more than 60 yrs.) In this elderly patient, ultrasound images of the right kidney shows three separate divisions of the renal pelvis- suggesting a trifid renal pelvis. The primary requirement is to drink at least 24 ounces of a clear liquid an hour or more before the procedure. Routine abdominal sonography of the abdomen in this patient revealed: a) kidneys located at a lower level than normal b) the lower poles of both kidneys pointing medially, c) a bridge of renal The kidney measures 7.71 cm Normal adult kidneys measure 9–12 cm longitudinally, 5–7 cm in transverse width and 3 cm in anteroposterior dimension [ 7 ]. in the lesion. Larger tumors (like the case above), may develop small aneurysms which can rupture and cause severe hemorrhage. Kidney tumors 5. Sonography shows multiple small cysts ranging from These types of renal fusion anomalies are associated with renal -This 15 yr old female patient showed mild pleural effusion and ascites on ultrasound imaging of the abdomen. These The left renal vein appears normal. This 3rd trimester pregnancy was imaged for fetal anomalies. -increased echogenicity of the renal cortex. A search for a pelvic kidney should immediately be performed if the kidney is not identified within renal fossa (Fig. The left kidney appeared to be normal. Such ectopic/ pelvic kidneys are usually complicated by infection and uretero-pelvic junction (pelvi-ureteric junction) obstruction. Reference: http://www.emedicine.com/med/topic2002.htm (free article). This is called crossed-ectopia. An ultrasound scan of the kidney can usually detect a kidney cancer. Kidney stones 3. This classification is a modification of the original Bosniak categorization of renal cysts. This is consistent with fatty liver. affecting a small part of the kidney. The kidney on this view measures 9.53 cm. 2. The renal US images dataset is divided into normal and abnormal class. Usually, AML is a benign tumor; however, The above ultrasound images show a cyst of 2.5 cms. Ultrasound images can show the following: Dr. Thomas Heston answered. in length, 8 to 10 cms. 2 ... 34 years experience Interventional Radiology. There is also evidence of a communication of the lesion with a segmental artery. This new term for a long understood normal variant, is used as the renal tissue in the column of Bertin does not show any evidence of hypertrophy. There is change in the fluid-debris interphase with change in position. The CT scan images shows hyperdense matter within the cyst with enhancement of the edges of the lesion, without enhancement of the contents (post contrast study). He had ESKD secondary to a posterior urethral valve and reflux nephropathy, for which he had undergone a deceased-donor kidney transplant. upper abdomen reveal a bridge of connecting renal tissue passing anterior to the maternal abdominal aorta, connecting both maternal kidneys. In late cases of pyelonephritis there may be focal abscesses and scarring of Abnormal renal rotation (renal malrotation) refers to an anatomical variation in the position of the kidneys, in particular to anomalous orientation of the renal hilum.It may occur unilaterally or bilaterally. This isthmus is seen passing anterior to the abdominal aorta. Reference: http://www.radswiki.net/main/index.php?title=Calyceal_diverticulum. The right kidney also appears considerably enlarged compared to its fellow. Ultrasound images reveal absent right kidney in right renal fossa. The ultrasound images above show a large subcapsular hematoma of the right kidney in a case of blunt abdominal trauma. sonoworld). Power Doppler image (bottom left) shows multiple vessels entering the mass. benign normal variant is junctional parenchyma. Color doppler images reveal swirling flow pattern within the cystic lesion. The current terminology for this b) 2 or These ultrasound images of the cross fused renal ectopia with bilateral duplication of the collecting system are courtesy of Dr Ravi Kadasne, MD. The main tests to diagnose kidney cancer are: imaging scans (ultrasound, CT, MRI and/or bone scans) to show the location of the cancer and whether it has spread Usually these patients are asymptomatic and the diagnosis is usually made on sonography or other modes of The column of Bertin is most commonly seen involving the left kidney as in the case above. The Reference:http://www.sonoworld.com/Sonoworld/Cases/Cases.aspx?CaseID=363(free article). both kidneys following renal biopsy some time ago. This lady also complained of hematuria. It is unusual to see the pelvic kidney so low down in the pelvis. The images above also show a fluid-debris level due to particulate matter within the cyst. 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