Diagnostic Ultrasound - Abdomen and Pelvis

Approach to Sonography of Renal Allografts
(Left) Longitudinal ultrasound
shows a calculus ſt
obstructing the transplant
ureter. There is moderate
hydronephrosis st. (Right)
Longitudinal ultrasound of a
poorly functioning renal
transplant shows increased
cortical echogenicity ſt and
decreased echogenicity of the
sinus fat st with prominent
pyramids . Biopsy showed
acute rejection.
Diagnoses: Kidney Transplant
(Left) Transverse ultrasound
with a needle guide shows a
biopsy needle ſt in the lower
pole cortex. An adequate
biopsy should include at least
10 glomeruli and 2 arteries
with 2 separate cores through
the cortex. (Right) Doppler
ultrasound shows a renal
transplant with poor function
in the early postoperative
phase. Absence of diastolic
flow ſt was secondary to
acute tubular necrosis causing
delayed graft function.
(Left) Power Doppler
ultrasound performed for poor
transplant function shows a
normal-sized kidney with no
internal flow consistent with
acute vascular thrombosis.
Artifacts st should be
interrogated with Doppler to
confirm that they do not
represent true flow. (Right)
Longitudinal color Doppler
ultrasound of a failed renal
transplant demonstrates
marked cortical thinning ſt,
sinus lipomatosis st, and
absence of color flow. This
was not acute thrombosis.
557