Us neonatal kidney

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Normal ultrasound of neonatal kidney.

Normal ultrasound of neonatal kidney.

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  • 1. Dr/Ahmed BahnassyConsultant radiologist RMH
  • 2. • Echostructure.• Size.• Variations.• Congenital anomalies.• Renal abnormality.
  • 3. RENAL ANATOMY MEDULLA RENAL CORTEX RENAL COLUMN MAJOR CALYCES RENAL PELVIS RENALURETER CAPSULE MINOR CALYX RENAL MEDULLARY PYRAMID
  • 4. NORMAL RENAL SONOGRAPHY• Paired retroperitoneal organs• Renal sinus- dense central echoes due to renal fat – Contains: • Collecting system: calyces, infundibula, & part of renal pelvis – bifid system seen as two separate lobulations • Renal vessels: renal hilium • Lymphatics • Fat • Fibrous tissues
  • 5. RENAL SINUS• Central area of the kidney from the medial border• Bounded by fat – anteriorly and posteriorly by fibrous sheath known as Gerota’s fascia – laterally by the laterocoronal fascia which becomes continuous with peritoneum & abdominal wall
  • 6. RENAL SONOGRAPHY• Renal parenchyma - 2 parts cortex & medulla – thickest at the renal poles • Cortex located between capsule & medulla – low level uniform echoes – less echogenic than liver & spleen – Columns of Bertin = columns of cortical tissue located between pyramids » can enlarge & mimic a mass » normal variant • medulla – renal volume is estimated by water displacement • V = 0.49 x length x width x anterior posterior dimension
  • 7. RENAL SONOGRAPHY• Renal parenchyma - 2 parts cortex & medulla – Medulla • Pyramids - triangular or rounded hypoechoic areas • Rounded zones of decreased echogenicity between cortex & renal sinus • Specular echoes interspersed at the junction of the cortex & medulla represents arcuate arteries & veins (known as corticomedullary junction)
  • 8. Dysplastic kidney
  • 9. RENAL SONOGRAPHY• Vascular exchange – renal arteries • come off of aorta - can be multiple • right renal artery (RRA) - seen posterior to IVC in sagittal plane – renal veins • come off of IVC • left renal vein (LRV) - seen between SMA & aorta in the transverse plane
  • 10. RENAL ARTERY
  • 11. RENAL SIZE
  • 12. Normal renal size Normal Liver, Spleen, and Kidney Dimensions in Neonates, Infants, and Children: Evaluationwith Sonography.. AJR:171,December19 98
  • 13. Development
  • 14. Anomalies and variations• Congenital variations – fetal lobulations – dromedary hump. – Fusion anomalies :horseshoe - isthmus of tissue that connects both kidneys – Ascent anomalies: pelvic kidney fails to migrate from pelvic area during embryology
  • 15. • Normal neonatal kidney should be evaluated according to:• Normal echotexture.• Normal size for age.• Normal development.• Excluding normal variants.• Diagnosing congenital anomalies ..and lastly evaluating a diseased kidney accordingly .