Diagnostic Ultrasound - Abdomen and Pelvis

Approach to Sonography of Renal Allografts
Diagnoses: Kidney Transplant
(Left) Longitudinal ultrasound
shows hypoechoic pyramids
ſt arranged around the
echogenic renal sinus st of a
normal renal transplant. The
cortex is intermediate in
echogenicity between the
pyramids and the sinus fat.
The iliacus muscle is noted
in this child. (Right)
Longitudinal ultrasound shows
an adult renal transplant.
Pyramids ſt are evident and
should not be mistaken for
calyces. The renal sinus st is
more echogenic than the renal
cortex .
(Left) Longitudinal color
Doppler ultrasound shows
color flow extending from the
renal sinus to the cortex
representing the normal
arborization of intrarenal
vessels from segmental ſt to
arcuate arteries . The renal
vein st and venous tributaries
are also well seen. (Right)
Power Doppler ultrasound is
more sensitive to vascular
flow, showing more detail of
the interlobular arteries .
The iliac artery ſt and renal
artery anastomosis st,
segmental and interlobar
arteries are demonstrated.
(Left) Longitudinal color
Doppler ultrasound of the
vascular pedicle shows the
iliac artery st and renal artery
ſt, and the iliac vein and
main renal vein . (Right)
Transverse oblique color
Doppler ultrasound shows the
course of the main renal
artery ſt. Angulation and
tortuosity can make Doppler
interrogation challenging. The
renal transplant is
echogenic.
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