Diagnostic Ultrasound - Abdomen and Pelvis

Approach to Sonography of Renal Allografts
Diagnoses: Kidney Transplant
(Left) Longitudinal ultrasound
of the renal pelvis shows a
stent ſt within the pelvis and
ureter. Stents are more
difficult to detect when the
ureter does not contain fluid.
(Right) Longitudinal
ultrasound of a renal
transplant shows urothelial
thickening st and gas within a
calyx. Ring down artifact ſt
allows detection of small
amounts of gas, which has
refluxed from the bladder.
Urothelial thickening is most
commonly secondary to
infection and rejection.
(Left) Longitudinal ultrasound
of a renal transplant shows
urothelial thickening in the
dilated renal pelvis st.
Consider infection, rejection,
and obstruction, and evaluate
the entire ureter. (Right)
Longitudinal ultrasound of a
patient with simultaneous
renal and pancreatic
transplant shows diffuse
circumferential urothelial
thickening ſt after removal of
a ureteral stent. There is
increased echogenicity of the
transplant kidney and
perinephric fluid st.
(Left) Longitudinal color
Doppler ultrasound shows a
renal transplant with
hydronephrosis . Color
Doppler can distinguish
dilated vessels from fluid-filled
collecting system. (Right)
Transverse color Doppler
ultrasound shows a dilated
proximal ureter ſt. This
should be traced to the
bladder to determine the level
of obstruction. The lower pole
calyx is dilated st.
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