How the kidneys look on ultrasound is normal and how pathology is determined can be found in this article. Here you will find the basic principles that experienced doctors’ use in their work.
A normal view of the kidneys on ultrasound
A complete ultrasound examination having high ultrasound scan cost of the kidneys includes an assessment of the location, orientation, axis, size, and echogenicity of the parenchyma, the contour, the nature of the centrally located echogenic disk and the lack of visualization of the proximal ureter. Normally, the kidneys are located in the retroperitoneal space along with the lumbar muscles and are oriented parallel to their course. They occupy an oblique position, and the upper pole is located dorsal to the lower pole.
The size of the kidney depends on the age; it is measured between the two poles and compared with known nomograms. From the point of view of ultrasound of the kidneys, the most important adjacent organ on the right is the liver, and on the left is the spleen. During the first few months of life, the kidney parenchyma may be iso- or hyperechoic compared with the liver or spleen, and then it becomes hypoechoic.
The cortex can be differentiated from the cerebral bylines, reflecting slight differences in echogenicity. The presence of cortico-medullary differentiation is an indicator of the normal structure of the kidney and the integrity of the parenchyma.
The contour of the kidney in children on ultrasound can be smooth, but often it has a lobed structure. Parenchymal lobules consist of a central pyramid covered with parenchyma of cortical substance and pillars located between the pyramids. With age, the lobed structure disappears, and the contour becomes smooth.
Abnormal development of the kidney on ultrasound
Anomalies or pathology of the kidneys in children can be divided into congenital and acquired, and anatomically- anomalies in the number, localization, vascular, parenchymal and abdominal systems.
One-sided kidney agenesis on ultrasound is often detected. Unilateral agenesis of the kidney is most often determined in children during an ultrasound scan conducted:
- With urination problems;
- When screening for related anomalies and
- About unrelated pathology.
On ultrasound in the renal fossa is not defined as a bean-shaped structure, and it may be located intestines. The surrounding organs are usually not changed. In such cases, it is important to conduct an ultrasound examination of the pelvis to prevent kidney dystopia. In infants, the adrenal glands are visualized in a normal anatomical position.
Kidney dystopia on ultrasonography
The kidneys begin their embryonic development in the large pelvis with the pelvis oriented anteriorly, and then they migrate to the renal fossa and complete the medial rotation by the 6th week of gestation. This process can be interrupted at any stage.
Renal vein thrombosis with an ultrasound scan
Ultrasound done by professional Ultrasound Clinics has a high diagnostic value for suspected renal vein thrombosis. Risk factors include dehydration, birth injury, and sepsis. During the acute phase, marked edema develops, and an ultrasound examines an increase in the kidney with a loss of corticomedullary differentiation. Due to edema at an early stage, the parenchyma looks hypoechoic, but with the progression of fibrosis, it becomes hyperechoic. Thrombi of small vessels look like radiant linear echogenic bands in the parenchyma. Atrophy and calcifications are visualized at a late stage in the thrombus localization zone. When color Doppler on ultrasound, there is a lack of venous blood flow.