24.06.2021

Interpreting the results ultrasound of the kidneys

Safe, informative, and accessible way to study an ultrasound scan of the kidneys, can be prescribed for a very wide range of indications. It is widely used as adult women and men, and children of different ages. In certain situations, renal ultrasound is performed even in the fetus, usually in the third trimester of pregnancy, which allows even before the birth of the child to diagnose the pathology of the urinary system.

How is the procedure

After appropriate training, consisting in diet for 3 days, the patient must come to the office ultrasound on an empty stomach and full bladder. The study is carried out in a sideways position and back, allowing you to get maximum information.

The patient’s skin is smeared with gel-like substance, to exclude the presence of air bubbles in the path of the ultrasound beam and the effect of the fibrous cover. Renal ultrasound in children should be done so that the child was calm, not crying, lay quietly and did not. This will enable the specialist to perform the procedure in full.

The procedure lasts 20-30 minutes, depending on the condition of the patient. Throughout the session the physician canolog defines various parameters and characteristics of the body and its vessels, capturing some moments in a photo to black and white (at ultrasonography) or in color (when dopplerography of the renal vessels, made by the DRC). After the research diagnostician draws the conclusion, which never contain a formulation of the clinical diagnosis.

Established contact with the child allows to obtain reliable data

The task of the expert performing ultrasound of the kidneys, is to provide the doctor all comprehensive data on the status of the test body. But he makes no conclusions about the diagnosis. Therefore, the conclusion contains only the information that reflects many parameters of the external and internal structure of the body or circulatory system. Based on these data and on results of laboratory tests and clinical symptom, the doctor gets the opportunity with maximum precision to diagnose the patient’s specific pathology and begin treatment.
What are the characteristics and parameters must be specified in the conclusion? A renal ultrasound transcript (norm or pathology) of the received data? Deal with this in more detail.

How is the interpretation of the ultrasound results

Every patient is different and has certain anatomical features. It can be tall or short, normal or overweight, asthenic or hypersthenic body type, young or elderly. Depending on these factors, through special calculations, identify indicators, which are referred to as the norm in deciphering ultrasound of the kidneys.

Those parameters that relate to dimensions, represented as a digital interval, characteristic for patients of a certain age. Developed special tables that help assess the pathology or normal ultrasound kidney quickly and correctly. These templates exist for both adult subjects and children, including newborns.

During the study, there are many options

In these tables presents the normal values, based on which, the doctor can decrypt the results, to assess the degree of deviation and, therefore, the stage and the danger of pathology. But having such data freely available and comparing them with the conclusion of the study, patients still should not engage in interpretation of the ultrasound results alone. This can lead to superficial and erroneous conclusions, the underestimation or overestimation of the perceived danger, the violation of psycho-emotional condition of the patient.
To make it easier to study such factors as the size of the kidneys in norm, their number and localization, internal structure and other parameters, it is possible to present them in the form of a table.

Settings In adult patients The children (with the rise 50-100 cm)
The number 2 2
Form Bean-shaped Bean-shaped
Size Length of the kidney – 100-12 mm, thickness – 40-50 mm, a width of 50-60 mm. allowed the difference in size of the left and right kidneys for no more than 20 mm. Length left kidney – 48-62 mm, right – 45-59 mm. Width of the left kidney – 22-25 mm, right – 22-24 mm. Thickness not measured.
Position The lower edge of the kidney is at the level of the 1-2 lumbar vertebra. The region of the right kidney is slightly lower due to the shift it down by the liver. The lower edge of the kidney is at the level of the 1-2 lumbar vertebra. Region of the right kidney is slightly lower due to the shift it down by the liver.
The thickness of parenchyma A maximum of 25 mm, the majority of people it is 15-23 mm. After 60 years, reducing the thickness to 10 mm is considered normal. On average 9-18 mm.
Capsule There is a clear level education with a thickness of 1,5 mm. There is a clear level of education up to a thickness of 1.0 mm.
Echogenicity capsule hyperechoic;
the parenchyma is more echogenic than the renal pyramids;
– ecoprotect renal cenusareasa density perinephric tissue;
– ecoprotect of the kidneys close to the echogenicity of the liver;
– cups and pelvis anechoic (if full bladder) and is not specified on the screen;
– allowed increased echogenicity of the cortex of the kidney (partial hypertrophy).
capsule hyperechoic;
the parenchyma is more echogenic than the renal pyramids;
– ecoprotect renal sinus is equal to the density of the perirenal tissue;
– ecoprotect of the kidneys close to the echogenicity of the liver;
– cups and pelvis anechoic (if full bladder) and is not specified on the screen;
– allowed increased echogenicity of the cortex of the kidney (partial hypertrophy).
Mobility when breathing The displacement of the buds on the inhale-the exhale does not exceed 20-30 mm. The displacement of the buds on the inhale-the exhale does not exceed 10-15 mm.
The outer contour Clear, smooth and smooth, without protrusions and the discontinuity line. Clear, smooth and smooth, without protrusions and the discontinuity line.

Transcript ultrasound of the kidneys includes not only comparing the obtained results with the existing norms. Doctor-sonolog shall describe in the conclusion of all found changes that will help in the future in the differential diagnosis of renal and other pathologies. So, in the wording of the conclusion have to be noted and described structural abnormalities, tumors and stones or microliths.

How to interpret deviations from the normal parameters

As for number of buds, everyone knows that it’s paired organ. In most people this is true, but there are patients with only one kidney. The second body may be removed due to injury or illness, or absent from the moment of conception of the fetus. There are also many cases when the intrauterine development of an organ is disturbed, which leads to abnormalities in the structure of the kidney: hypoplasia or aplasia, cystic. In these cases the second kidney is, but it is not functional. In addition, the complete or partial doubling of the organ.

It looks on ultrasonography the partial doubling of the kidneys

The standards relating to the dimensions of the body are averages. The doctor conducting the study in a particular patient, be sure to take into account his height, weight, complexion. Therefore, it is allowed a slight deviation of digital values from accepted norms, but not more than 10 mm. If this difference exceeds 1 cm, even for one parameter, then the Clinician should understand the reasons.

So, reducing the size of one or both kidneys may occur in chronic inflammatory processes, infectious or autoimmune nature. The increase is often a result of increased exudation and swelling in acute inflammation or evidence of tissue proliferation in the tumors.

Often nephroptosis, or drooping of the kidney.

It can be single or double – sided and have 3 degrees, depending on the level of reduction of the lower edge of the body:

  • 1 degree – prolapse at a height of 1.5 lumbar vertebrae;
  • 2 the degree – 2 and more vertebrae;
  • Stage 3 – on-3 and more vertebrae.

The parenchyma, or own the body tissue, which includes the main functional and structural units called nephrons, can increase or decrease the thickness as a result of various pathological processes. Thus, the thickening often talks about acute inflammation, and reducing the thickness of degenerative changes. Chronic infectious pathology of the kidneys (pyelonephritis), nephropathy or hypertension gradually lead to a decrease in parenchymal thickness and its compaction. In addition, it should be borne in mind and age.

Changes ehoplotnosti structures of the kidney expressed much

A very important in conclusion, ultrasound of the kidneys marked changes in echogenicity. Various structures of the kidney have different density, and its deviations from the norm clearly indicates pathology. So, the appearance of cystic formations filled with air or fluid, which gives significant changes in echogenicity. The presence of a tumor of the kidney or perinephric tissue, and an abscess, suggests made by the diagnostician description of some education, having a certain size and shape, uncharacteristic ecoprotect, clear or fuzzy boundaries.

Pelvis, underneath the layers of the renal parenchyma should also be presented in the conclusion. Their shape may be altered due to the presence of large concretions or tumors in their space can be microliths (sand), and the mucous membrane is often thickened as a result of inflammatory processes or trauma sharp edges of the stones.

All ultrasound findings should be explained by the attending physician, taking into account the specific features of the patient and his disease. Timely detection of pathology identified by ultrasound examination, is able to preserve human health and often save lives.

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