Ultrasound of the Upper Urinary Tract Flashcards
cortex appearance on US
moderate echogenicity and echo texture
(hypoechoic to liver and spleen)
medulla appearance on US
hypoechoic, mixed echotexture
(hypoechoic to cortex)
renal pelvis appearance on US
hyperechoic due to fat
what imaging planes are used in an US of the kidney
parasagittal (longitudinal)
transverse
what is transverse plane good for imaging
renal pelvis
can iD pelvic dilation, renal papillary necrosis, and disruptions to renal architecture
normal size of a kidney in cats
3-4.3 cm
normal size of a kidney in dogs
variable - depends on size of dog
ddx for large kidneys
acute nephritis (pyelonephritis)
hydronephrosis
polycystic disease
neoplasia (lymphoma)
compensatory hypertrophy
ddx for small kidneys
congenital dysplasia/aplasia
chronic nephritis
chronic pyelonephritis
normal kidney margins
smooth, kidney bean shaped
abnormal kidney margins
irregular, round, lumpy
mottled echotexture
indicates:
1. infiltration (inflammation or neoplasia)
2. ischemia/infarction
appearance of acute infarcts
hypoechoic and wedge-shaped
appearance of chronic infarcts
hyperechoic w/ fibrous striations
appearance of chronic pyelonephritis
fibrous striations
loss of CM junction
mottled parenchyma
in what patient signalment is it normal to have increased renal echogenicity
old, fat, male cats
dogs NEVER have hyperechoic kidneys in health
ddx for hyperechoic kidneys
ethylene glycol toxicity
fibrosis (interstitial nephritis, glomerulonephritis, amyloidosis)
ddx for hypoechoic kidneys
edema
uniform masses
simple masses
singular, well defined areas of cavitation
ddx: benign mass, usually cyst-like
complex masses
multiple masses with striations and mottled texture
ddx: pyogranulomatous fungal infection or neoplasia
retroperitoneal fluid
halo of hypoechoic/anechoic fluid around the renal capsule
ddx: acute kidney injury
pyelectasia vs hydronephrosis
pyelectasia: low pressure dilation of pelvis, non obstructive and does not cause splitting of parenchyma
hydronephrosis: high pressure dilation of calyces/crest, obstructive and causes splitting of parenchyma
renal papillary necrosis
loss of/shrunken renal papilla above renal pelvis
urinary bladder appearance on US
hypoechoic
variable wall thickness depending on how full it is
what classifies as a thickened bladder wall
> 3 mm
apical lesions: inflammation
trigone lesions: neoplasia
diffuse lesions: inflammatory, lymphoma
cystic calculi
mineralizations on the bottom on the bladder
