Home Stomatitis Ultrasound of the kidneys: how the results are interpreted. What can a kidney ultrasound show and how to decipher the result of an ultrasound examination? Ultrasound of kidney abnormalities

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Ultrasound of the kidneys: how the results are interpreted. What can a kidney ultrasound show and how to decipher the result of an ultrasound examination? Ultrasound of kidney abnormalities

Today, methods for diagnosing kidney disease increasingly include ultrasound examination. Its indicators can determine probable diseases or pathological manifestations.

Using ultrasound, the numerical value, localization, contours, shape and size, and structure are revealed. In addition, the presence of neoplasms, inflammatory and edematous processes is determined.

It is possible to visualize blood flow. The main indications for ultrasound are abnormalities in urine output, the presence of blood in urine, pain signs in the lower back, injuries, inflammation, poor test results. Ultrasound helps to examine health or progressing disease, and choose the right therapeutic treatment.

How is the procedure carried out?

Having passed the necessary preparatory stage, consisting of a three-day diet, the patient comes for an ultrasound. The urine container must be completely filled. The examination is carried out in a supine position (back or side), which makes it possible to obtain the maximum amount of information. Skin covering the patient is lubricated special gel so as not to allow air bubbles to appear in the path of the ultrasonic beam and not to interfere with the hair.

When performing ultrasound in children, young patients should remain calm, not cry, lie still and not move. All this allows you to perform the procedure to the maximum extent.

The duration of the session takes no more than half an hour, its time depends on the patient’s condition. During the session, the doctor examines various parameters of the organs and records certain moments in color or black and white. Upon completion of the study, a conclusion is drawn up, which does not contain a clinical diagnosis.

Parameters and indicators studied

During ultrasound examination study:

Ultrasound results in women and men

There are no differences in the diagnosis of kidneys in patients of different sexes. The norms of values are absolutely the same. Only for women there are slightly different values that the kidneys take during pregnancy. Normally, the kidneys elongate by a couple of centimeters, and the ureters may dilate somewhat. When deciphering an ultrasound of the kidneys, the norm in adults should be in the following parameters:

thickness – from 4 to 5 cm;
length – from 10 to 12 cm;
width – from 5 to 6 cm;
the thickness of the working area is from 1.5 to 2.5 cm.

Ultrasound results in children

Examination of organs in small patients is performed in the same way as for adults. Prescribing an ultrasound infant, it is necessary to take into account possible anomalies in the formation of the kidneys, possible hereditary signs, difficulties during pregnancy and childbirth, resuscitation of newborns, changes in indicators in urine identified during the tests.

A study in older children is prescribed after testing if there are signs of pain in the lower back or abdomen, injury, or problems with urination.

When visualizing organs in newborns, there are features associated with the small size of organs that have not completed their development.

The normal sizes of kidneys in children are shown in the table:

Pelvis dimensions

For patients of the adult age category, the size of the pelvis in its normal state should not exceed one centimeter. There is an exception in pregnant women, when an increase in the size of the pelvis is a normal phenomenon:

first three months– anteroposterior size of the right pelvis – up to 1.8 cm, of the left – up to 1.5 cm;
in the second trimester indicators reach 2.7 and 1.8 cm.

For children, these sizes are much smaller - about 0.6 cm.

Interpretation of ultrasound results and identification of kidney pathologies

All patients are unique anatomical features. Height can be high or low, weight can be normal or overweight, age category also has its influence. Taking into account all factors and performing special calculations, doctors determined the indicators that represent the norm.

Size parameters are represented by digital intervals characteristic of different age categories. Special tables have been compiled with which you can evaluate pathological changes or the norm for the kidneys quickly and competently.

Deciphering the information received should include not only comparative analysis information with existing normalized data. In his conclusion, the sonologist must pay attention to the description of all detected changes, which should help in diagnosing renal diseases.

The final formulation should note and describe in detail structural changes of an abnormal nature, the appearance of neoplasms, stones, or.

Concepts and terminology

The quality of ultrasound examination data largely depends on the competent preparation of the patient for the procedure. While studying structural features parenchyma, the concept of “echogenicity” is used. In a healthy state, the organ tissue looks uniform. Hypoechogenicity can describe structural structure, appears as a spot on the device monitor white. It can be homogeneous or heterogeneous if there is an alternation of normal tissue areas and areas with increased echogenicity.

The concept “” confirms the presence of a significant displacement of the kidneys from their usual place to the pelvic region or to the abdomen. During such a disease, disturbances in the removal of urine from the kidneys are observed, pressure increases in them, and blood circulation worsens.

Most often, this problem occurs in the kidney located on the right. The left one is able to fall much less often. It is very rare, but prolapse of both kidneys occurs simultaneously.

The term “microcalculosis” is usually understood as the identification of stones or stones in organs that can come out on their own.

“MCD” stands for “urate diathesis”, which confirms the presence of urate sand.

If the term “space-occupying formations” appears in the transcript of ultrasound readings, then it should be understood as detected neoplasms - or an abscess.

The pelvis located under the parenchymal layer should also be described in the conclusion. Their shapes may change due to the presence of stones large sizes or neoplasms. They may contain microliths, the mucous membrane is often thickened due to ongoing inflammation or injury from the sharp edges of the stone.

All received data must be deciphered by a specialist who will take into account any characteristics of the patient. Timely detected pathologies on ultrasound can preserve the patient’s health and even save life.

Pathological damage

To confirm the presence of kidney injuries, an ultrasound examination is also prescribed. There are five conventional categories for injuries to this organ, taking into account the level of severity of pathologies:

What diseases does ultrasound detect?

As it became known from statistical data, with the help ultrasound examination Up to ninety-seven percent of kidney diseases can be detected. By comparing the information obtained as a result of the procedure with established standards, it becomes possible to diagnose nephroptosis, dystrophy, inflammatory process in vessels, cyst formation, hematomas and much more.

It must be remembered that only experienced doctor is able to correctly decipher data, determine accurate diagnosis, draw up a therapeutic course.

Ultrasound diagnostics of pathology of the urinary system received positive feedback from both medical workers, and in patients. Ultrasound diagnostics of nephropathology in women during pregnancy is of particular importance. She has won a worthy place among diagnostic procedures, thanks to its safety, simplicity and effectiveness. For example, the main method for diagnosing hydronephrosis is ultrasound. Quite often prescribed in conjunction with ultrasound of the bladder and its ducts.

For greater information, ultrasound of the kidneys is often prescribed in conjunction with an examination of the bladder and its ducts. This gives the doctor the opportunity to see the full picture of the pathology urinary system

Indications for ultrasound of the urinary system

Any examination, even one as safe and non-traumatic as an ultrasound examination, must be carried out according to indications. For ultrasound examination, the reasons for conducting diagnostics are:

observation at chronic diseases organs of the urinary system (pyelonephritis, glamerulonephritis, cysts, etc.);
preventive examination;
regular headaches of a migraine nature, as well as against the background of hypertension;
swelling lower limbs, faces;
endocrine diseases;
congenital pathologies of the genital organs;
injuries and pain in the lumbar region;
disturbance of urination (frequency, incontinence, pain during the process), suspicion of hydronephrosis;
renal colic;
changes in OAM data (protein, blood, mucus in urine).

Ultrasound is also prescribed when the patient experiences the first symptoms of foreign bodies in the kidneys to identify their parameters and structure. An examination is carried out if there is a violation of the outflow of urine to identify inflammation and determine the size of the renal pelvis, if the development of malignant neoplasms, with severe edema in pregnant women, as well as to determine the location of the kidneys and their size during a medical examination.

Pathologies detected by ultrasound diagnostics

What does a kidney ultrasound show? The ultrasound diagnostic procedure can detect a number of changes in the urinary system from simple to very serious:

inflammatory diseases of the urinary system (for example, nephritis);
traumatic diseases;
congenital anomalies;
neoplasms;
diseases vascular system kidneys (it is possible to perform an ultrasound scan of the kidney vessels);
damage to parenchymal tissues;
injuries;
hydronephrosis.

Parameters assessed during ultrasound examination

During ultrasound diagnostics, the number of organs (one, two, the presence of an additional organ), mobility, location and shape, parameters and structure are assessed, the renal pelvis and ureters are studied. In the normal state of the body, the mobility of organs is not great and amounts to up to one and a half centimeters. In case of prolapse or the so-called “wandering” kidney, mobility increases.

Normal position of the kidneys- on both sides spinal column(left is higher than right). However, they can change their location and be on one side (one under the other), in the pelvic area (this prolapse of the kidneys is called nephroptosis).

Normal form for this organ - bean grain. In case of developmental anomalies, the organs can take the shape of a horseshoe, the English letters “S” and “L”, and sometimes their fusion is observed.

The normal shape of the kidneys resembles the outline of beans. However, with the development of pathologies, they can take the form of a horseshoe or English letter"S"

One of the most important diagnostic indicators is the size of the kidneys. These parameters are different for children and adults. For children, there is a separate table with the norms of indicators and their interpretation. But no matter what the specifics of interpreting the results of kidney ultrasound in children or pregnant women may be, most diseases of the urinary system are accompanied by changes in the size of the kidneys (for example, hydronephrosis leads to an enlargement of this organ).

Normal size indicators kidneys in an adult are as follows:

the thickness of the renal parenchyma is about 23 mm;
length is 100-120 mm;
the organ has a width of 40-50 mm;
the thickness of the organ is about 45-55 mm, the thickness of the renal capsule is about 1.5 cm;
one organ weighs 120-200 grams.

An increase in these parameters indicates inflammatory processes: we can talk about pyelonephritis, hydronephrosis. A decrease occurs with hypoplasia and some other diseases and developmental anomalies.

There is also a decrease in kidney parenchyma with age, after surgical interventions associated with kidney removal. The remaining organ, taking over the functions of its distant counterpart, may undergo changes in the direction of increase.

Structure a healthy kidney is not homogeneous, the contours are visualized as smooth and clear. The development of any disease affects this structure. Compaction of some structures indicates inflammation, the presence of foreign formations (conglomerates, stones) indicates the accumulation of sand and stones or the development of a tumor. Echo signs of hydronephrosis are: enlargement of the affected organ and accumulation of fluid in its cavities.

Calyces and renal pelvis normally should not be visualized. They are anechoic in nature and are determined by ultrasound diagnostics only when they develop pathological process. For example, dilation of the pelvis indicates the development of pyelonephritis, hydronephrosis and calculosis.

Ureters Normally they have a length of 25-30 cm; normally on ultrasound they have light walls with a dark cavity. In the case of pathological bends, shortening/lengthening of the ureters, the outflow of urine is disrupted and development infectious processes. Duplication of the ureters may also occur, and the place where the ureter opens into the kidney may be blocked by a valve. In addition, there may be a stone in the ureter. All these changes will be revealed by ultrasound.

Ultrasound examination makes it possible to determine the presence of stones in the ureters so that the doctor can take timely measures to neutralize them

Interpretation of ultrasound data and doctor’s report

Interpreting kidney ultrasound is the job of a qualified specialist. However, anyone can familiarize themselves with the basic concepts that may appear in the ultrasound diagnostic doctor’s conclusion. The following results are often encountered:

Volumetric echo-positive formations are neoplasms. In the case of homogeneity, we are talking about a benign formation. In case of heterogeneity and uneven contour of the formation, we are talking about a malignant tumor.
Cysts are located as non-echoic (anechoic) space-occupying formations. Their parameters and contents are indicated in the conclusion.
Microliths are sand or small stones up to 3mm.
Conglomerate (echo-shadow, hyper-echo-like formation) – stones.
The presence of hypoechoic zones in renal parenchyma indicates edema ( common symptom pyelonephritis).
The presence of hyperechoic zones in the renal parenchyma is evidence of hemorrhage.
A spongy structure may indicate congenital cystosis.
An enlarged pelvis indicates hydronephrosis and ureteral obstruction.
Consolidation of the mucous membrane of the renal pelvis indicates swelling of the tissue, this is another evidence of pyelonephritis.

Renal pelvis: description

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Parameters: norm and deviations

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Normal in children

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Fetal parameters

Diseases

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Pyeelectasis

Hypotension

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Hydronephrosis

A condition in which the renal pelvis is enlarged and structural changes tissue is called hydronephrosis. There are acquired and congenital. The latter is caused by abnormalities that cause narrowing of the ureter. Acquired diseases of the urinary system:

oncological neoplasms; vesicoureteral reflux; trauma; urolithiasis; fetal pressure on surrounding organs in pregnant women.

Symptoms of hydronephrosis include painful sensations in the lumbar region of a dull and aching nature. Sometimes renal colic is observed, blood and other impurities in it (acetone, protein) sometimes appear in the urine. Treatment consists of surgical intervention and eliminating the cause, which is an obstacle to the full outflow of urine from the body.

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Kidney stone

The left and right kidneys are susceptible to the formation of stones in the pelvis, which form food substances entering the body year after year and bad condition metabolism. The growth of some is within minimal limits, which allows them to easily exit the body in urine. Others reach critical dimensions and lead to blockage of the pelvis, followed by rupture of the kidney.

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Cyst formations

A rare pathology for the renal pelvis is a cyst, which has an oblong outline and is usually located in the lumen of the renal pelvis. The internal filling of cysts is liquid, which is limited on the outside by a connective tissue capsule. Such formation leads to the fact that urine is poorly drained, as a result of which an infectious process occurs in the affected organ.

Why they form is still completely unknown, but there is an opinion that this is facilitated by infection or kidney damage, less often by heredity or congenital developmental anomalies. The course of the disease is often not accompanied visible symptoms, therefore, it is possible to clearly determine them only when passing preventive examinations. As the tumor grows, the following may appear:

stupid or nagging pain in the lumbar region; frequent urination, sometimes with pain; fever; pain in muscles and joints.

The standard methods for determining this disease are x-rays, tomography, ultrasound, general analysis blood and urine. Treatment of an ordinary cyst does not require the intervention of a doctor, but complications require additional intervention in the form of operations of a specific nature. It is even possible to remove a kidney if a tumor has ruptured, for example, the right kidney, or a malignant process has joined.

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Calyx with tumor

Tumor in renal pelvis develops slowly, and its first symptoms are blood in the urine and lumbar pain.

The normal size of the kidneys can increase due to tumors of the renal pelvis, which are extremely rare. The incidence is 1.4% per thousand males and 0.6% per thousand females per year. But the beginning of each year is marked by an increase in this percentage due to improved diagnostics. Therefore, doctors advise undergoing annual examinations.

The first manifestations of tumor formations in the kidney are blood in the urine, lower back pain, sudden weight loss, frequent nausea and vomiting. The reasons for the appearance of this symptomatology include: bad habits(smoking, alcohol), uncontrolled intake medicines, love for smoked meats and fatty dishes. If a tumor is suspected, the doctor does:

palpation of the abdomen; checks blood and urine tests; ultrasound examination; tomography. Return to contents

Anomaly: double pelvis

Sometimes there are cases when a double renal sinus is observed. The kidney has two pelvises, which form two systems with separate ureters connecting them to bladder. The double pelvis acquires such forms even at the stage of fetal development under the influence of teratogenic factors (radiation, hormones, etc.). Normal healthy man may not be aware of the presence of such an anomaly for many years before a random examination of the organs of this system. Treatment comes down to taking specialized medications, less often surgical intervention.

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Injuries and damage

Rupture of the renal pelvis is accompanied by the release of urine into the perinephric space, and then spreading along the psoas muscle. The HSV test shows that kidney function and heart rate are normal. Very often the rupture is diagnosed as a small tear of the kidney, which is erroneous. The gap is confirmed at retrograde pyelography. The most dangerous is spontaneous, which is a consequence of advanced hydronephrosis. The consequences of such a process form real threat for the patient's life.

The human kidney is an important organ that functions as a kind of filter for the body, and the renal pelvis and calyces are unified system, functioning inside of this body. This component is a kind of sedimentation tank for secondary body fluid, which then enters the ureter for subsequent excretion.

The renal pelvis is an area of the organ in which important processes of filtration and fluid storage occur.

Renal pelvis: description

The renal pelvis is a cavity whose main function is to collect urine, the formation of which occurs in the kidney. In appearance, it resembles a funnel formed by a small and large calyx, each of them has a narrowing - a neck, which is a kind of connecting element of the pelvis and the calyx system. Any violations in the form of blockages lead to an increase in this component.

The renal pelvis has a body: a muscular organ, internally covered with a mucous membrane, the walls of which are endowed with longitudinal and transverse smooth muscles. This structure provides contractile movements of the pelvis to move fluid through the urinary tract. One of the main features of the walls is their impermeability to all substances.

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Parameters: norm and deviations

In medicine, there are generally accepted standards for the size of the pelvis for all age categories of people. From the fetus to the elderly, there are boundaries within which the parameters of the renal pelvis vary. Any deviations indicate the presence of a particular disease, the timely identification of which will help to begin treatment and avoid negative consequences and complications.

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Adult sizes (+ during pregnancy)

The normal size of the renal pelvis in an adult should not exceed 10 mm. In women during pregnancy, the pelvis is enlarged, which is considered normal for this state. In the first trimester, the size of both pelvis reaches 18 mm, and in the last stages - 27 mm. The main reasons for enlargement in the absence of pregnancy are:

tumors; bending or twisting of the urinary tract; stones in the ureters.

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