Renal Vessels: Sonographic Evaluation and Disease Flashcards
RRA vs LRA
RRA is longer and courses posterior to the IVC to reach the kidney
Normal renal arterial flow demonstrates
low resistance, monophasic flow
The renal artery origins are the most common site of
stenosis with atherosclerotic disease
The interlobar arteries course
perpendicular to the renal capsule and flow moves parallel to the ultrasound beam. This provides the most accurate doppler tracing of the parenchymal arterial flow.
The arcuate arteries course
parallel to the renal capsule and Doppler evaluation is difficult because the flow is perpendicular to the ultrasound beam.
Renal/aortic ratio normal
<3.5
Renal artery PSV normal
<180 cm/s
Normal renal artery
Note the presence of the low resistance waveform with rapid upstroke and peaked appearance. The early systolic peak (ESP) is visualized.
Normal Resistive Index
<0.7
Renal Artery Stenosis
Stenosis in the renal artery will cause decreased resistance with a significantly increased velocity and diastolic flow.
Fibromuscular Dysplasia
FMD is most commonly a diffuse process that can affect many arteries in the body. It is most commonly seen in the renal arteries. Consider this diagnosis when bilateral RAS is present, especially in younger patients. Angiography is the preferred modality to diagnose FMD
Renal Stent
The renal stent is a durable mesh cylinder that helps maintain a patent lumen in the renal artery. The materials used are usually echogenic in nature.
Renal Allograft
The external iliac vessels are the most common vessels used for renal transplant.
The most common anatomic variant of the renal arteries is the
presence of 2 or more renal arteries
Renal artery stenosis is most commonly caused by
atherosclerosis
The most common site of atherosclerotic stenosis is at
the origin of renal arteris
The most common site of stenosis caused by FMD is in the
mid-distal renal arteries
Renovascular HTN and Renal Stenosis is the most common cause of
secondary HTN
Recent onset of uncontrollable HTN is the most common indication for
renal duplex exam
FMD is most commonly seen in the
renal arteries of young women
Renal vein thrombosis is most commonly caused by
primary renal disease
Crest syndrome most commonly affects the
tiny parenchymal arteries in the renal circulation.
Right iliac fossa most common site for
renal transplant
External iliac artery most commonly used for
arterial anastomosis
External iliac vein is the most common site for
venous anastomosis
Renal transplant rejection is most commonly caused by
Acute Tubular Necrosis (#1 acute cause)
Stenosis at the arterial anastomosis is the most common complication of
renal transplant
