This document discusses ultrasonography of the kidneys, ureters, bladder, and prostate. It describes the uses and advantages of ultrasound, including showing renal anatomy without radiation or contrast. Limitations include limited tissue penetration. Key findings seen on kidney ultrasound are described, such as the distinction between cortex, medulla, and sinus. Common pathologies are then outlined, including simple cysts, polycystic kidneys, kidney stones, hydronephrosis, pyelonephritis, nephrocalcinosis, and kidney tumors. The anatomy and pathologies of the ureters, bladder, and prostate are also briefly covered.

1. Ultrasonography

2. Values of ultrasound :
-
1 show renal parenchyma
-
2 detection of UT calculi
-
3 renal and bladder masses
-
4 congenital anomalies

3. Advantage of Ultrasound:
-
1 save
-
2 don t need patients preparation
-
3 not invasive
-
4 reliable
-
5 affordable
-
6 no contrast media
-
7 No radiation

4. Disadvantages of ultrasound :
-
1 limited tissue penetration
-
2 limited fields of view
-
3 difficulty imaging obese or heavier muscles
patients.
-
4 limited functional information
-
5 inability to image certain structures as lung
and bowel.

5. The Kidney

6. In kidney ultrasound we notice the:
-
1 Size
-
2 Thickness
-
3 perirenal space
-
4 counter
-
5 parenchyma ))echogenicity((
And compared with liver
* Liver more than cortex
* cortex more than medulla
* sinus more than cortex

9. normal view
the first one 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

10. The transverse view it 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

12. Simple renal cyst
dislocated in this
region we can see it
very round and it
will have posterior
acoustic
enhancement,

13. Another appearance of the
longitudinal 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

14. In polycystic kidney disease
we 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

15. A longitudinal view
of the right kidney
There are multiple
cysts againe with
posterior acoustic
enhancement and
anechoic round
structures

17. Longitudinal view of the
renal 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 strong
followed by a dark
area of acoustic
shadowing always
behind the stone

19. Transverse view ,
Staghorn caculi are
larg calculi which
involve the renal
pelvis and at least
two calluses of the
kidney, this has
heavier shadowing

20. In the longitudinal
view we 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

22. The renal pelvis is
diallted but the
renal calluses are
not diallted

23. In the grade 2
hydronephrosis
both the renal
pelvis and
calluses are
diallted

24. In grade 3
hydronephrosis the
renal pelvis and
calluses are diallted
but to a greater
degree as compared
to grade 2
hydronephrosis and
we also can see some
cortical thinning

25. Grade 4
hydronephrosis show
very large degree of
dilation evolving the
entire kidney and
there is higher
amount higher
degree of cortical
thining and it is lead
to renal atrophy

26. The pyelonephritis
may cause abnormal
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

27. Another
longitudinal view of
pyelonephritis,
which hoses the
medulla as well
very clearly and we
can see the
abnormal
echogenicity the
hyperechoic region

28. The transverse view
of pyelonephritis
show us the
hyperechoic area and
some hypoechoic
area it is overall
heterogeneous
appearance

29. Nephrocalcinosis is a
condition in 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

30. The density of the
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

31. Chronic kidney
disease also causes
increased
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. Now we study the 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

33. In grade 2
echogenicity,
the renal
echogenicity
is more than
the liver

34. In renal failure the
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

35. Angiomyolipoma
is a beingne renal
tumer which
consists of
vascular smooth
muscle and fat
tissue it usually
around mass
which is
somewhat
hyperechoic

36. Another longitudinal
view of the kidney,
showing
angiomyolipoma here
we can see the
rounded hyperquak
mass in the lower
pole of kidney

37. Wilm's tumor is a
rare kidney tumor
that occurs in the
children, and we
can see a large
heterogeneous
mass located in
the upper pole of
the kidney

38. Renal cell carcinoma
is a malignant
condition of the
kidney, we can also
see heterogeneous
mass in the lower
pole of the right
kidney in the
longitudinal view

40. Crossed fused ectopia is
a 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

41. In the renal
trauma, the
hypoechoic and
heterogeneous
areas are due to
the hemorrhage
and hematoma

42. Ureter The

43. Normally the ureter not
seen in the ultrasound but
it seen if there is dilation
because of stones or
stricture or obstruction

44. In this image we 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

45. urinary bladder

46. Normal view of the fullness bladder

47. Longitudinal
view of the
normal dilated
bladder and in
the right the
transverse view

48. Cystitis is
inflammation of
the bladder and
we can notice
that the thickness
of the bladder is
more than five
millimeters

49. A stone in the
bladder with
posterior
shadowing, the
stone appears
hyperechoic

51. Bladder cancer
usually called
traditional cell
carcinoma appears
as rounded
metrogenous or
round hypoechoic
mass orginted from
the wall of the
bladder

52. Prostate

53. Normal view