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renal ultrasound.pptx
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- 2. Values of ultrasound 1.showrenal parenchyma 2.detection of UT calculi 3.renal and bladder masses 4.congenital anomalies
- 3. Advantage of Ultrasound 1.Save 2.donot need patients preparation 3.not invasive 4.Reliable 5.Affordable 6.no contrast media 7.No radiation
- 4. Disadvantages of ultrasound 1.limitedtissue penetration 2.limited fields of view 3.difficulty imaging obese or heavier muscles 4. patients 5.limited functional informationa 6.inability to image certain structures as lung and bowel
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- 6. In kidney ultrasoundwe notice the 1. Size 2. Thickness 3. perirenal space 4. Contour 5. parenchyma
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- 8. • The normaladult renal length, measured by ultrasound, is 9–12 cm • the kidneys should be smooth in outline • The parenchyma surrounds a central echodense region (the renal sinus) consisting of the pelvicaliceal system • There may be a difference between the two kidneys, normally of less than 1.5 cm.
- 10. normal view the firstone is coronal view ,we can see the left kidney and the renal parenchyma which consists of cortex the outer region and the middle on the inner hyperechoic region but in this image it isn t very clear the middle loss and we have the hyperechoic region which is the renal sinus fat because it has fat getting more dense and it is appear hyperechoic and below we can see the renal pelvis but we can not see the ureter because normally we don t really see the ureter In the longitudinal view we have the right kidney and the liver above that and we can appreciate the kidney, it has the outer cortex and renal sinus Which are very well visualized in this picture
- 11. The transverse viewit is across sectional image of the kidney The right image we can see more clearly, we have the cortex and renal sinus very well visualized also we can see the renal pyramids and renal pelvis
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- 13. Now we studythe creating of cortical echogenicity now the norma one will always be the renal echogenicity that will be less than the liver echogenicity as we can see here the cortex is hypoechoic as compared to the liver In the right side this grade one echogenicity we can see the liver parenchyma and the cortex of the kidney have similar echogenicity, they are matching
- 14. In grade 2 echogenicit y,the renal echogenicit y is more than the liver
- 15. In renal failurethe kidney is very hyperechoic and it is also reduced in size, this one we can see almost six centimeters only whereas the normal size rang is above nine centimeters
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- 17. Longitudinal view of therenal stone, you can see there is a stone lgdged in the kidney and it has shadowing, it is followed by stream of dark regions and this is the whole kidney and we have a shadowing behind the hyperechoic stone
- 18. Another image of transverse view Hyperechoic strongfollowed by a dark area of acoustic shadowing always behind the stone
- 19. Transverse view , Staghorncaculi are larg calculi which involve the renal pelvis and at least two calluses of the kidney, this has heavier shadowing
- 20. In the longitudinal viewwe can not appreciate as well as in the longitudinal view, we can see multiple stones which is involving a much larger region as a compared to the solitary stone we saw earlier and we can see one acoustic shadow
- 21. Nephrocalcinosis is a conditionin which calcium deposited in the renal parenchyma, most common locations is the middle and we can see the hyperechoic region, these are the calcium deposits through medullry regions
- 22. The density ofthe calcification is more in this image ,that's why it lead to shadowing posterior acoustic Shadowing is another one over here and this one is also in the medullry region, it has occupied the medullry pyramids
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- 25. The pyelonephritis may causeabnormal echogenicity in the kidney, the regions that are hyperechoic they are due to hemorrhage and the regions that are hypoechoic they are due to edema
- 26. The transverse view of pyelonephritis showus the hyperechoic area and some hypoechoic area it is overall heterogeneous appearance
- 27. Another longitudinal view of pyelonephritis, which hosesthe medulla as well very clearly and we can see the abnormal echogenicity the hyperechoic region
- 28. Chronic kidney disease also causesincreased echogenicity of the kidney along with some poor visualization of structures such as medullry pyramids We don't see them very clearly in these images
- 32. The renal pelvis is dialltedbut the renal calluses are not diallted
- 33. In the grade2 hydronephros is both the renal pelvis and calluses are diallted
- 34. In grade 3 hydronephrosis therenal pelvis and calluses are diallted but to a greater degree as compared to grade 2 hydronephrosis and we also can see some cortical thinning
- 35. Grade 4 hydronephrosis show verylarge degree of dilation evolving the entire kidney and there is higher amount higher degree of cortical thining and it is lead to renal atrophy
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- 39. Simple renal cyst dislocated inthis region we can see it very round and it will have posterior acoustic enhancement,
- 40. Another appearance of thelongitudinal view it is more detailed we can see this is in the upper pole of the kidney Ther is again the acoustic enhancement which is behind the cyst it will be hyperechoic region because more ultrasound rays are passing through the cysts so it give enhancement
- 41. In polycystic kidney diseasewe have multiple cysts around anechoic structures with posterior acoustic enhancement there will be multiple of them ,there is one in the cortex and we can see in the transverse field the renal parenchyma, most of them are in the near renal sinus or the medullry region and there will be more than one It is an inherted disorder
- 42. A longitudinal view ofthe right kidney There are multiple cysts againe with posterior acoustic enhancement and anechoic round structures
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- 44. Angiomyolipom a is abeingne renal tumer which consists of vascular smooth muscle and fat tissue it usually around mass which is somewhat hyperechoic
- 45. Another longitudinal view of thekidney, showing angiomyolipoma here we can see the rounded hyperquak mass in the lower pole of kidney
- 46. Wilm's tumor is arare kidney tumor that occurs in the children, and we can see a large heterogeneous mass located in the upper pole of the kidney
- 47. Renal cell carcinoma isa malignant condition of the kidney, we can also see heterogeneous mass in the lower pole of the right kidney in the longitudinal view
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- 53. Crossed fused ectopia isa condition in which both kidneys are found fused together, here we can see the tow separate renal sinuses and also groove here that separate both kidneys and this is on the left side ,In the right side in this case will be empty it will not have any kidneys
- 54. Normal Crossed fusedectopia
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- 66. In the renal trauma,the hypoechoic and heterogeneous areas are due to the hemorrhage and hematoma
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- 69. Normally the ureternot seen in the ultrasound but it seen if there is dilation because of stones or stricture or obstruction
- 70. In this imagewe see the proximal ureter that is somewhat dialted because of the presence of a stone and it causing dilation of the renal pelvis as well in the grade 1 hydronephrosis
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- 73. • The urinarybladder should be examined in the distended state • the walls should be sharply deined and barely perceptible • The bladder may also be assessed following micturition, to measure the post micturition residual volume of urine.
- 74. Longitudinal view of the normal dilated bladderand in the right the transverse view
- 75. Normal view ofthe fullness bladder
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- 78. A stone in thebladder with posterior shadowing, the stone appears hyperechoic
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- 81. Cystitis is inflammation of thebladder and we can notice that the thickness of the bladder is more than five millimeters Cystits
- 82. Acute cystitis chroniccystitis
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- 84. Bladder cancer usually called traditionalcell carcinoma appears as rounded metrogenous or round hypoechoic mass orginted from the wall of the bladder
- 86. Ultrasound sacn from apatient showing small tumor within the bladder
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- 97. • Transrectal ultrasound(TRUS)can show the overall size of the prostate and can diagnose relatively small masses within its substance • ultrasound cannot distinguish benign from benign malignant disease when conined to the prostate,except on the basis that masses in the peripheral zone are likely to be malignant and those in the central zone are more likely to beign. • Transrectal ultrasoundguided biopsy is used extensivel for the diagnosis of prostatic carcinoma
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