Hepatic

Veins

Spleen

Celiac
axis
Liver
SMA Left
Right
Renal artery kidney
kidney
Renal vein

AORTA
IVC
RENAL SCANNING APPROACHES
 APPROACH TO SCANNING

LIVER STOMACH

SPLEEN
I
K K
AORTA
IVC
S Left kidney: requires a posterior
Right kidney scanning approach, through the spleen
approach: anterior, lateral, Air-filled bowel impedes anterior
posterior scanning
Liver is the acoustic
window
 ANATOMY

8-12 cm long, 4-5 cm wide, 3-4 cm thick

Medullary pyramids
Kidney Anatomy
Minor
Calyx

Renal artery
Major
Calyx
Renal vein

Sinus

Ureter
Medulla

Renal capsule
Cortex
 SONOGRAPHIC APPEARANCE

• Cortex is mid-gray, less echogenic than

liver or spleen.

• Medullary pyramids are hypoechoic

• Renal sinus is echogenic due to fat

• Capsule is smooth and echogenic

 SONOGRAPHIC APPEARANCE

• Renal pelvis and ureter become visible

when dilated
• They appear black (Hypoechoic)
RIGHT KIDNEY LONG AXIS
Anterior

Superior Inferior
Liver
Sinus

Cortex

Diaphragm

Posterior
RIGHT KIDNEY SHORT AXIS
Anterior

Right Left
GB Liver

IVC

R Kidney
Vertebral Aorta
Body Renal a.

Posterior
RENAL PATHOLOGY
 RANGE OF HYDRONEPHROSIS

Normal Mild Moderate Severe

 RENAL PATHOLOGY

4. RENAL PARENCHYMAL CHANGE

 RENAL PARENCHYMAL CHANGE

GADE I

GADE II

GADE III
RENAL PATHOLOGY

Renal Cysts
 RENAL CYSTS

Arise in the renal cortex,

Usually single / may be multiple
Cysts do not communicate; hydronephrosis does
Shape is round or oval
Echo free (Anechoic) BLACK
Sharp interface between the mass and renal tissue
RENAL ABSCESS
RENAL PATHOLOGY

3. RENAL STONES
RENAL STONES
URETERIC CALCULI
RENAL PATHOLOGY

4. RENAL MASSES
RENAL MASSES
PERINEPHRIC COLLECTION
 NORMAL VARIANTS

Dromedary humps:
Lateral kidney bulge, same echogenicity as the cortex
 NORMAL VARIANTS

Hypertrophied column of Bertin:

Cortical tissue indents the renal sinus
 NORMAL VARIANTS

Double collecting system:

Sinus divided by a hypertrophied column of Bertin
 NORMAL VARIANTS

Horseshoe kidney:
 NORMAL VARIANTS

Renal ectopia:
One or both kidneys outside the
normal renal fossa
URINARY BLADDER

TRANSVERSE SCAN
URINARY BLADDER

LONGITUDINAL SCAN
 BLADDER PATHOLOGY

1.URINARY BLADDER STONE

 BLADDER PATHOLOGY

1.URINARY BLADDER STONE

 ACUTE
CYSTITIS

1-Debris at the base of urinary

bladder with floating bright
reflectors
 ACUTE
CYSTITIS

1-Debris at the base of urinary

bladder with floating bright
reflectors

2- Mucosal Irregularity
 ACUTE
CYSTITIS

1-Debris at the base of urinary

bladder with floating bright
reflectors

2- Mucosal Irregularity

3- Increased wall thickness

BLADDER
MASS
ENLARGE
D
MEDIAN
LOBE OF
PROSTAT
E
PRACTICE TEST
CALCULUS AT PELVIURETERIC
JUNCTION CAUSING MILD
HYDRONEPHROSIS
 GRADE II TO III RENAL
PARENCHYMAL CHANGE
ENLARGED PROSTATE
RENAL CYST
PYONEPHROSIS
NEPHROCALCINOSIS
 CYSTITIS
FOLEYS BALOON INITU
RENAL CALCULUS
LEFT VUJ CALCULUS