Diagnostic Ultrasound - Abdomen and Pelvis
Ureters and Bladder Liver URETER Anatomy: Pelvis Dilated calyx Vertebral bodies Dilated ureter Dilated renal pelvis Reverberation artifact Normal left ureteral jet Right UVJ stone causing twinkling artifact, with absent ureteral jet Mild hydronephrosis Significant urothelial thickening (Top) Longitudinal transabdominal grayscale ultrasound of the right kidney shows a dilated pelvicalyceal system and proximal ureter. The ureter is normally not visible on ultrasound unless it is dilated as seen here. (Middle) Oblique color Doppler ultrasound of the suprapubic region shows calculus at the right ureterovesical junction (UVJ) causing twinkling artifact with absent ureteral jet. Normal left ureteric jet is seen. (Bottom) Longitudinal transabdominal ultrasound of the left kidney shows significant urothelial thickening of the pelvicalyceal system and proximal ureter in this patient with known extramedullary hematopoiesis. 117
Ureters and Bladder Anatomy: Pelvis URINARY BLADDER Internal echoes Layering echogenic debris Urinary bladder wall Urinary bladder Diverticulum Prostate Prostatic urethra Diverticulum neck Urine jet at diverticulum neck Bladder diverticuli (Top) Transverse transabdominal ultrasound of the bladder shows floating internal echoes with layering echogenic debris in this patient with cystitis. (Middle) Graphic shows a diverticulum arising from the lateral urinary bladder wall due to herniation of the mucosa and submucosa through the muscular wall. (Bottom) Transverse oblique transabdominal color Doppler ultrasound through the bladder shows 2 well-distended bladder diverticuli along the left posterolateral bladder. Urine jet is identified in 1 of the diverticular necks. 118
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Ureters <strong>and</strong> Bladder<br />
Anatomy: <strong>Pelvis</strong><br />
URINARY BLADDER<br />
Internal echoes<br />
Layering echogenic debris<br />
Urinary bladder wall<br />
Urinary bladder<br />
Diverticulum<br />
Prostate<br />
Prostatic urethra<br />
Diverticulum neck<br />
Urine jet at diverticulum neck<br />
Bladder diverticuli<br />
(Top) Transverse transabdominal ultrasound of the bladder shows floating internal echoes with layering echogenic debris in this patient<br />
with cystitis. (Middle) Graphic shows a diverticulum arising from the lateral urinary bladder wall due to herniation of the mucosa <strong>and</strong><br />
submucosa through the muscular wall. (Bottom) Transverse oblique transabdominal color Doppler ultrasound through the bladder<br />
shows 2 well-distended bladder diverticuli along the left posterolateral bladder. Urine jet is identified in 1 of the diverticular necks.<br />
118
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