indications for pediatric renal ultrasound
hydronephrosis, palpable mass, abdominal distention, anuria, oliguria, hematuria, sepsis or UTI, myelomeningocele, chromosomal or VATER and VACTERL anomalies, abnormal external genitalia, prune belly syndrome
transducer in a premature infant or used to provide better detail resolution when pathology is suspected
9 to 12 MHz Linear Array
In infant and young child, the _____ ____ ____ are obtained from a prone position, whereas older children and adolescents will be scanned in the decubitus position
dedicated renal views
renal length pay be ___ ____ from a prone position, as well as dependent pelviectasis may occur
slightly shorter
what is large and hypoechoic and should not be mistaken for dilated calyces or cysts
medullary pyramids
___ ___ ___ in neonate and pediatric patient allows for clear distinction of cortical-medullary differentiation
less cortical fat
increased cortical echogenicity results from
glomeruli occupying larger portion of cortical volume and location of 20% of looped of Henle within cortex as opposed to medulla
arcuate arteries
lie at bases of medullary pyramids; appear as punctate, intensely echogenic structures
____ __ ____ ____ usually lobulated from residual fetal lobulations
contour of neonatal kidney
the normal renal length varies with
the age of the neonate or pediatric patient
what kidney is somewhat longer
left kidney
the left adrenal gland extends
slightly more medial than does the right
the central adrenal medulla in the neonate is relatively thin, appearing as a
distinctly echogenic stripe, surrounded by the more prominent and less echogenic adrenal cortex
When the kidney is absent or ectopic, the ipsilateral adrenal gland remains in
the renal fossa, but as a result it may have an altered configuration
The normal urinary bladder is thin-walled in the distended state and should measure less than
3 mm (with a mean of 1.5 mm) in anterior-posterior dimension
when empty, the bladder wall thickness increases but remains
less than 5 mm
pelvic kidney
located in the pelvis instead of the abdomen
horseshoe kidney
lower poles fused together to form a U shape
crossed ectopic
the cortex are fused together and they are on the same side
renal duplication
has 2 ureters draining the kidney rather than one; they may drain into the bladder independently or as one
congenital urinary tract anomalies
hydronephrosis
patent urachus
multi cystic dysplastic kidney disease (MCDK)
sonographic features of congenital hydronephrosis
visible renal parenchyma surrounding central cystic component, small peripheral cysts (dilated calyces) budding off large central cyst(extra renal pelvis), and visualization of dilated ureter(functional dilation)
Vesicoureteral reflux (VUR)
common nonobstructive cause of hydronephrosis and is indicated in up to 33% of prenatally diagnosed hydronephrosis
sonographic finding of ureteropelvic junction obstruction
pelvocalyceal dilation without ureteral dilation
