Renal Vessels: Sonographic Evaluation and Disease

Question 1

RRA vs LRA

Answer 1

RRA is longer and courses posterior to the IVC to reach the kidney

Question 2

Normal renal arterial flow demonstrates

Answer 2

low resistance, monophasic flow

Question 3

The renal artery origins are the most common site of

Answer 3

stenosis with atherosclerotic disease

Question 4

The interlobar arteries course

Answer 4

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.

Question 5

The arcuate arteries course

Answer 5

parallel to the renal capsule and Doppler evaluation is difficult because the flow is perpendicular to the ultrasound beam.

Question 6

Renal/aortic ratio normal

Answer 6

<3.5

Question 7

Renal artery PSV normal

Answer 7

<180 cm/s

Question 8

Normal renal artery

Answer 8

Note the presence of the low resistance waveform with rapid upstroke and peaked appearance. The early systolic peak (ESP) is visualized.

Question 9

Normal Resistive Index

Answer 9

<0.7

Question 10

Renal Artery Stenosis

Answer 10

Stenosis in the renal artery will cause decreased resistance with a significantly increased velocity and diastolic flow.

Question 11

Fibromuscular Dysplasia

Answer 11

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

Question 12

Renal Stent

Answer 12

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.

Question 13

Renal Allograft

Answer 13

The external iliac vessels are the most common vessels used for renal transplant.

Question 14

The most common anatomic variant of the renal arteries is the

Answer 14

presence of 2 or more renal arteries

Question 15

Renal artery stenosis is most commonly caused by

Answer 15

atherosclerosis

Question 16

The most common site of atherosclerotic stenosis is at

Answer 16

the origin of renal arteris

Question 17

The most common site of stenosis caused by FMD is in the

Answer 17

mid-distal renal arteries

Question 18

Renovascular HTN and Renal Stenosis is the most common cause of

Answer 18

secondary HTN

Question 19

Recent onset of uncontrollable HTN is the most common indication for

Answer 19

renal duplex exam

Question 20

FMD is most commonly seen in the

Answer 20

renal arteries of young women

Question 21

Renal vein thrombosis is most commonly caused by

Answer 21

primary renal disease

Question 22

Crest syndrome most commonly affects the

Answer 22

tiny parenchymal arteries in the renal circulation.

Question 23

Right iliac fossa most common site for

Answer 23

renal transplant

Question 24

External iliac artery most commonly used for

Answer 24

arterial anastomosis

Question 25

External iliac vein is the most common site for

Answer 25

venous anastomosis

Question 26

Renal transplant rejection is most commonly caused by

Answer 26

Acute Tubular Necrosis (#1 acute cause)

Question 27

Stenosis at the arterial anastomosis is the most common complication of

Answer 27

renal transplant