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Adrenal Hemorrhage

KEY FACTS Imaging Unilateral or bilateral, round or oval, well-defined mass Variable echogenicity depending on stage of hemorrhage Variable appearance depending on age of hemorrhage US: Nonspecific, avascular hypoechoic, hyperechoic, or heterogeneous lesion CT/MR: Can better characterize hemorrhagic contents of lesion, increasing specificity Acute hematoma: Hyperechoic Subacute hematoma: Mixed echogenicity ± central hypoechoic area Chronic hematoma: Hypo- or anechoic cyst-like lesion Curvilinear calcification, internal echoes/layering debris…

Renal Transplant Rejection

KEY FACTS Imaging No specific imaging characteristics Ultrasound-guided renal biopsy is gold standard Acute rejection (AR): Nonspecific allograft edema, urothelial thickening Resistive index (RI) may be elevated, or there may be loss or reversal of arterial diastolic flow Elevated RI > 0.80 in early postoperative period associated with increased risk of graft failure Chronic rejection (CR): Cortical atrophy, increased echogenicity, calcification Color perfusion may be decreased…

Transplant Renal Vein Thrombosis

KEY FACTS Imaging Enlarged, edematous, hypoechoic kidney due to outflow obstruction Absence or decreased color flow in renal vein at hilum Patent renal artery early, later renal artery will thrombose also High systolic arterial peaks with flow reversal in diastole Color, power, spectral Doppler US is 1st-line imaging modality for complications of renal transplantation You’re Reading a Preview Become a Clinical Tree membership for Full access…

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