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Dr. Yash Kumar Achantani
Dr. Yash Kumar Achantani
Dr. Yash Kumar Achantani
Most accessory renal arteries arise from the abdominal aorta, but they may also
originate from the common iliac, superior or inferior mesenteric, adrenal, and
right hepatic arteries.
The right renal vein is located anterior to the right renal artery.
The left renal vein lies between the superior mesenteric artery and the
aorta (as opposed to the splenic vein, which lies anterior to the superior
mesenteric artery).
The left renal vein may normally be quite large in a supine individual.
Anomalous left renal vein
The left renal vein may following a retroaortic course passing
posterior to the aorta instead between the aorta and SMA.
Circum Aortic Left Renal Vein
ANTERIOR APPROACH
In most cases the anterior approach is used to evaluate the main RAs.
Anterior Approach
OBLIQUE APPROACH
By moving the probe to the left of midline and angling toward the
patient's right, an acceptable Doppler angle of 60 degrees is
achieved. To avoid aliasing set the colour scale high enough so it is
minimized. If the scale is too low then it is difficult to determine
which vessel is the vein and which vessel is the artery.
Anterior Approach Oblique Approach
The Doppler sample volume is placed The Doppler reading of the abdominal
within the proximal right renal artery. aorta is taken near the level of the
In this view, an acceptable Doppler renal arteries.
angle of 60 degrees or less is easily This value is applied to the RAR .
obtained.
Spectral Doppler US image of the right RA in a normal subject. Note the small spike occurring at the end of
the systolic rise. This feature is seen only in a normal main RA.
Normal Doppler waveforms obtained from the main renal artery and segmental
renal artery
The early systolic peak (ESP) (arrow) is seen as a small notch in systole in the
normal intrarenal arterial waveform(segmental and arcuate artries ). The systolic
upstroke is rapid with an acceleration time of 0.07 seconds or less.
Bilateral Renal Doppler
Clinical information
Findings
Kidney length for age
Mean +/- Standard deviation: cm +/- cm
Right kidney
Size: -------cm
Morphology: Location, contour,length.
Focal parenchymal thinning: Mild/Moderate/ Severe
Hydronephrosis: Mild/Moderate/ Severe
Main renal artery peak systolic velocity:
Ostium: cm/s
Proximal: cm/s
Mid: cm/s
Distal: cm/s
Resistance index:
Main renal vein: Patency and waveform (normal or abnormal)
Left kidney
Size: -------cm
Morphology: Location, contour,length.
Focal parenchymal thinning: Mild/Moderate/ Severe
Hydronephrosis: Mild/Moderate/ Severe
Main renal artery peak systolic velocity:
Ostium: --- cm/s
Proximal: --- cm/s
Mid: ---cm/s
Distal:--- cm/s
Resistance index:
Main renal vein : Patency and waveform (normal or abnormal)
Ureters
Urinary bladder
Impression
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