Us neonatal kidney

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Normal ultrasound of neonatal kidney.

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Us neonatal kidney

  1. 1. Dr/Ahmed BahnassyConsultant radiologist RMH
  2. 2. • Echostructure.• Size.• Variations.• Congenital anomalies.• Renal abnormality.
  3. 3. RENAL ANATOMY MEDULLA RENAL CORTEX RENAL COLUMN MAJOR CALYCES RENAL PELVIS RENALURETER CAPSULE MINOR CALYX RENAL MEDULLARY PYRAMID
  4. 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. 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. 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. 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. 8. Dysplastic kidney
  9. 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. 10. RENAL ARTERY
  11. 11. RENAL SIZE
  12. 12. Normal renal size Normal Liver, Spleen, and Kidney Dimensions in Neonates, Infants, and Children: Evaluationwith Sonography.. AJR:171,December19 98
  13. 13. Development
  14. 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. 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 .

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