Renal Pathology Ultrasound Quiz

Renal Pathology

• Terminology related to urinary tract pathology includes: Haematuria, Polyuria, Oliguria, Anuria, Hesitancy/poor stream, Dysuria, Proteinuria, and Glomerular filtration rate (GFR)
• Renal obstruction, renal infection, parenchymal disease, renal tumors, and trauma are common renal pathologies

Simple Renal Cysts

• Most common renal mass, incidence increases with age (rare < 30 yrs, common > 60 yrs, 33% benign)
• Epithelial lined and fluid filled, solitary or multiple, usually asymptomatic
• Ultrasound criteria: Anechoic, Round or ovoid, Thin, smooth, well-defined wall, Posterior enhancement
• Location: Cortical (within the cortex of the kidney), Exophytic (extending from the surface of the kidney), Parapelvic (within the renal sinus, may mimic hydronephrosis or extra-renal pelvis)

Complex Renal Cysts

• Not meeting simple cyst criteria, may contain internal echoes, septations, calcifications, thickened/irregular walls, and mural nodules
• CT may be needed to determine if benign or malignant

Polycystic Disease (ADPKD)

• Autosomal dominant, most common hereditary renal disorder
• Develops around 30-40 years old, increasing cyst size and number, correlating with decline in renal function
• Diagnosis: Positive family history, increasing cyst volume and number
• May present with pain, haematuria, hypertension, UTI, renal failure (50% by 60), liver cysts (30-60%), pancreatic cysts (10%), and splenic cysts (5%)
• Ultrasound appearance: Grossly enlarged kidneys, innumerable, bilateral, asymmetrical cysts, disrupted parenchyma

Hydronephrosis

• Dilatation of the renal collecting system (pelvis and calyces) due to obstruction of urine outflow
• Causes: Calculi, urinary retention, masses, enlarged prostate, scarring/post-infection, neurogenic bladder, vesicoureteric reflux
• Ultrasound appearance: Dilatation of pelvicalyceal system, thinning of parenchyma with acute obstruction, atrophy with long-standing severe obstruction

Renal Calculi

• Affects approximately 12% of the population, increasing incidence with age
• Calcium oxalate most common (60-80%), may cause haematuria, flank pain or infection
• Usually located in the collecting system, single or multiple
• Common areas of narrowing in the ureter where stones may become lodged: PUJ, ureter crosses iliac vessels, VUJ
• Bladder Calculi: Caused by renal stone migration, usually asymptomatic, may cause bladder pain, haematuria

Test your knowledge of renal pathology in ultrasound imaging with this quiz. Covering topics from lecture 10 of the FRD3061 Medical Imaging Science and Methods 2Ultrasound 1 course, this quiz will help you review and reinforce your understanding of renal ultrasound imaging and related pathologies.