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Transplant Renal Artery Stenosis

KEY FACTS Imaging Color, power, spectral Doppler US is screening modality for transplant renal artery stenosis Stenosis occurs most commonly at arterial anastomosis but can occur along length of artery Focal elevation of peak systolic velocity (PSV) > 250-300 cm/s at stenosis with poststenotic turbulence Color aliasing and soft tissue vibration at area of stenosis Renal artery to Iliac PSV ratio > 1.8-3.5 Secondary sign: Tardus…

Renal Transplant Hydronephrosis

KEY FACTS Imaging Dilated renal pelvis and calyces ± dilated ureter Distended bladder may cause functional obstruction or reflux resulting in hydronephrosis Low-level echoes within lumen suggest pus (pyonephrosis) or blood (hemonephrosis) Highly echogenic shadowing intraluminal structures represent stones, twinkling artifact on color Doppler Urothelial thickening suggests infection or rejection Ultrasound is sensitive and specific for hydronephrosis but may be limited for site of obstruction You’re…

Renal Infarct

KEY FACTS Terminology Global or focal renal hypoperfusion → tissue ischemia and eventually, parenchymal loss You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Renal Lymphoma

KEY FACTS Terminology Primary: Involvement of kidneys without evidence of other organ or nodal involvement; extremely rare: < 1% Secondary: Dissemination of extrarenal lymphoma; more common You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Renal Angiomyolipoma

KEY FACTS Imaging Discrete renal mass with varying amounts of dysmorphic blood vessels, smooth muscle, and mature adipose tissue Variable size, can be very large Single or multiple Classic angiomyolipoma (AML): Lipid-rich echogenic mass with posterior acoustic shadowing Fat-poor subtype ("AML with minimal fat"): Usually hyperechoic but fat not detected by CT or MR CT/MR more specific than US Color Doppler: Absent from fatty component, may…

Renal Cell Carcinoma

KEY FACTS Imaging Variable appearance: Solid, cystic, or complex Solid: Homogeneous or heterogeneous, hypervascular soft tissue components and areas of necrosis, calcifications Cystic variant: Unilocular or multilocular, fluid-debris levels (hemorrhage and necrosis), thick and irregular wall or septations, nodules Use Doppler for detection of internal vascularity RCC may be initially detected by US, but CECT and MR are primary tools for characterization and staging US may…