Diagnostic Ultrasound - Abdomen and Pelvis

Complex Renal Cyst
(Left) Transverse Doppler US
shows a complex cyst with a
thin internal septation st and
potential nodule . Although
there is no color Doppler flow,
contrast-enhanced imaging is
more sensitive for detecting
internal flow. (Right)
Longitudinal contrastenhanced
US of the right
kidney ſt shows an exophytic
cyst with a thin, smooth
internal septation . A few
microbubbles are seen in the
septation with no other
enhancement, confirming a
benign complex cyst. (Courtesy
P. Sidhu, MD.)
Diagnoses: Urinary Tract
(Left) Longitudinal US shows a
suspicious lower pole cystic
lesion ſt with an internal
mass-like nodule , which is
suspicious for a malignant
lesion. (Right) Color Doppler
US in the same patient does
not demonstrate internal color
flow , which is most
consistent with a hemorrhagic
cyst with retracting clot.
However, Doppler imaging is
insensitive for detecting subtle
vascularity, and contrastenhanced
imaging is
recommended.
(Left) Longitudinal US in a
transplant kidney shows a
complex upper pole cystic
lesion with a septation st and
nodule , which is suspicious
for potential malignancy.
(Right) Transverse T1 C+ MR
subtraction image in the same
patient shows the presence of
enhancement within the
septations st, consistent with
a Bosniak III lesion.
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