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Showing posts with label USG Renal. Show all posts
Showing posts with label USG Renal. Show all posts

Case 97: Hepatic Mild Steatosis with Renal Cortical Bosniak I Cyst || Ultrasound

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Clinical Features:

A 53-year-old female patient


Ultrasound Features:

  • The liver parenchyma is homogeneously echogenic with mild attenuation of the ultrasound beam. 
  • Tiny anechoic well-defined cyst is seen at the left renal interpolar cortex.


Ultrasound Diagnosis:

Hepatic mild steatosis (Grade I)

Left renal interpolar tiny cortical cyst (Bosniak I)


Ultrasound Images:





The liver parenchyma is homogeneously echogenic with mild attenuation of the ultrasound beam. 
H/o cholecystectomy


Tiny anechoic well-defined cyst is seen at the left renal interpolar cortex.


Case 90: Acute Nephropathy with Urinary Bladder Debris || Ultrasound

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Clinical Features:

A 12-year-old female patient came with fever, burning micturition & left back pain.


Ultrasound Features:

  • Swollen & echogenic left kidney with accentuation of corticomedullary differentiation.
  • Urinary bladder debris.
  • Mild hepatomegaly.


Ultrasound Diagnosis:

  • Left-sided acute nephropathy, possibly pyelonephritis. Urine RME can easily exclude glomerulonephritis.
  • Urinary bladder debris.
  • Mild hepatomegaly.


Ultrasound Images:



Mild hepatomegaly


Right kidney & gallbladder


Swollen & echogenic left kidney




Urinary bladder lumen filled with debris


Renal parenchyma on Doppler


Swollen & echogenic left kidney with accentuation of corticomedullary differentiation.


Hazy pyramids on high-frequency ultrasound


Urinary bladder debris on high-frequency ultrasound





Case 81: Bilateral Ureteric Calculi Causing Obstructive Uropathy

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Ultrasound Features:

- Bilaterally enlarged kidneys with echogenic parenchyma & moderate pelvicalyceal system dilatation.

- An echogenic structure casting acoustic shadow on grayscale & twinkling artifact on color Doppler, is noted at the right distal ureteric lumen causing proximal dilatation.

- Another echogenic structure casting acoustic shadow on grayscale & twinkling artifact on color Doppler, is noted at the left mid ureteric lumen causing proximal dilatation.


Ultrasound Diagnosis:

Bilateral obstructive uropathy due to right distal ureteric & left mid ureteric calculi causing bilateral moderate hydroureteronephrosis (Grade III)


Ultrasound Images:

Right:

 

Enlarged right kidney with echogenic parenchyma & moderate pelvicalyceal system dilatation.


Right distal ureteric calculus casting acoustic shadow on grayscale & twinkling artifact on color Doppler 


Right distal ureteric calculus casting acoustic shadow on grayscale & twinkling artifact on color Doppler with proximal dilatation


Right distal ureteric calculus 


Right distal ureteric calculus 


Left:


Enlarged left kidney with echogenic parenchyma & moderate pelvicalyceal system dilatation.


Left mid ureteric calculus


Left mid ureteric calculus with proximal luminal dilatation






Case 79: Mild Fatty Liver (Grade I) & Renal Cortical Cyst (BOSNIAK I)

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Ultrasound Features:

- Hepatic parenchymal echogenicity is homogeneously increased with mild attenuation of the ultrasound beam with well-visualization of intrahepatic vessels & diaphragm. 

- A well-defined small anechoic cystic area with a sharp margin, posterior acoustic enhancement & no internal solid component or septation is noted at the interpolar cortex of the right kidney.


Ultrasound Diagnosis:

- Mild fatty change in the liver (Grade I)

- Right renal cortical cyst (BOSNIAK I)


Ultrasound Images:



Mild fatty change in the liver (Grade I)


Right Renal Cortical Cyst (BOSNIAK I)







Case 76: Small Renal Cortical Cyst (BOSNIAK-I)

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Ultrasound Features:

- There is a small well-defined anechoic cystic area with sharp & thin margin with no internal septation, calcification or solid component is noted at the interpolar cortical region of left kidney


Ultrasound Diagnosis:

Left renal small cortical cyst (BOSNIAK-I)


Ultrasound Images:



Left Kidney


Left renal small cortical cyst (BOSNIAK-I)





Case 75: Gross Hydronephrosis (Grade IV) due to PUJ Obstruction

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Clinical Features:

A 2-month-old male child was brought with a history of antenatal bilateral mild urinary tract dilatation.


Ultrasound Features:

- Right kidney is normal.

- Left kidney shows gross pelvicalyceal system dilatation forming an 'Elephant Footprint' appearance with thinning of the parenchyma

-No dilated left ureter is not visualized beyond the renal pelvis.


Ultrasound Diagnosis:

Left-sided gross hydronephrosis (Grade IV) due to PUJ obstruction


Ultrasound Images:



Normal right kidney


Normal right kidney in a magnified image


Left kidney shows gross pelvicalyceal system dilatation forming an 'Elephant Footprint' appearance with thinning of the parenchyma


Left renal antero-posterior renal pelvis diameter (AP RPD): 20 mm


Left kidney shows gross pelvicalyceal system dilatation forming an 'Elephant Footprint' appearance with thinning of the parenchyma


Normal partially filled urinary bladder





Case 58: Renal Calculus || Nephrolithiasis || Ultrasound

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Clinical Features:

A 28 years old male patient came with left flank pain.


Ultrasound Features:

A bright echogenic structure casting posterior acoustic shadow on gray scale & twinkling artifact on color Doppler is noted within the left renal pelvis with mild pelvicalyceal system dilatation & increased renal parenchymal echogenicity.


Remember:

Color Doppler twinkling artifact is a useful finding to confirm tiny urinary calculus in confusing cases.


Ultrasound Images:




Fig: A bright echogenic structure casting posterior acoustic shadow on gray scale & twinkling artifact on color Doppler is noted within the left renal pelvis with mild pelvicalyceal system dilatation & increased renal parenchymal echogenicity.


YouTube Video Link:


https://youtu.be/ek61F1eF7rU


Case 37: Ureteral Mass || Ultrasound

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Clinical Features:

A 42 years old male patient came with

- Hematuria

- Right flank pain.


Ultrasound Features:

There is a hypoechoic intraluminal soft tissue mass noted in the mid to distal right ureter causing obstructive features, i.e. proximal hydroureter & moderate hydronephrosis.


Ultrasound Images:


Fig: Right sided moderate hydroureteronephrosis


Fig: Dilated right ureter


Fig: Dilated right ureter with hypoechoic lumen at mid part


Fig: Hypoechoic mass within dilated mid ureter; scan done transabdominally using TVS probe


Fig: Hypoechoic mass within dilated mid ureter


Fig: Hypoechoic mass within dilated mid ureter


Fig: Hypoechoic mass within dilated mid ureter

YouTube Video Link:



https://youtu.be/sJwNATKaJH8






Case 35: Renal Calculus || Nephrolithiasis || Twinkling Artifact

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Clinical Features:

A 66 years old female patient came with right flank pain.


Ultrasound Features:

A bright echogenic structure casting posterior acoustic shadow on grayscale & twinkling artifact on color Doppler is noted within the right renal sinus.


Ultrasound Images:


Fig: A bright echogenic structure casting posterior acoustic shadow on grayscale & twinkling artifact on color Doppler is noted within the right renal sinus.



Fig: A bright echogenic structure casting twinkling artifact on color Doppler is noted within the right renal sinus.


YouTube Video Link:



https://youtu.be/dJWHtba_CNw