Diagnostic Ultrasound - Abdomen and Pelvis

09.07.2019 Views

Kidneys KIDNEY ARTERIES AND INTERIOR ANATOMY Anatomy: Abdomen Adrenal Arcuate arteries Cortical column (of Bertin) Interlobar arteries Inferior adrenal artery Interlobular arteries Superior segmental artery Posterior segmental artery Renal artery Anterior superior segmental artery Anterior inferior segmental artery Inferior segmental artery Renal pyramid Pelvic & ureteric branches Renal papilla Renal cortex The kidney is usually supplied by a single renal artery, the 1st branch of which is the inferior adrenal artery. It then divides into 5 segmental arteries, only 1 of which (the posterior segmental artery) passes dorsal to the renal pelvis. The segmental arteries divide into the interlobar arteries that lie in the renal sinus fat. Each interlobar artery branches into 4 to 6 arcuate arteries that follow the convex outer margin of each renal pyramid. The arcuate arteries give rise to the interlobular arteries that lie within the renal cortex, including the cortical columns (of Bertin) that invaginate between the renal pyramids. The interlobular arteries supply the afferent arterioles to the glomeruli. The arterial supply to the kidney is vulnerable, as there are no effective anastomoses between the segmental branches, each of which supplies a wedge-shaped segment of parenchyma. 47

Kidneys Anatomy: Abdomen CT UROGRAM 12th rib Minor calyces Renal pyramids Major calyces Renal pelvis Ureter Urinary bladder A coronal reconstruction of a series of axial CT sections can be viewed as a surface-rendered 3D image to simulate an excretory urogram. The window levels and work station controls have been set to optimally display the renal collecting system. The color scale is arbitrary; in this case, opacified urine is displayed as white. Less dense urine within the renal tubules in the pyramids and the diluted urine within the bladder are displayed as red. The CT scan was obtained in suspended inspiration, resulting in caudal displacement of the kidneys. In the supine position at quiet breathing, the upper poles of the kidneys usually lie in front of the 12th ribs. 48

Kidneys<br />

Anatomy: <strong>Abdomen</strong><br />

CT UROGRAM<br />

12th rib<br />

Minor calyces<br />

Renal pyramids<br />

Major calyces<br />

Renal pelvis<br />

Ureter<br />

Urinary bladder<br />

A coronal reconstruction of a series of axial CT sections can be viewed as a surface-rendered 3D image to simulate an excretory<br />

urogram. The window levels <strong>and</strong> work station controls have been set to optimally display the renal collecting system. The color scale is<br />

arbitrary; in this case, opacified urine is displayed as white. Less dense urine within the renal tubules in the pyramids <strong>and</strong> the diluted<br />

urine within the bladder are displayed as red. The CT scan was obtained in suspended inspiration, resulting in caudal displacement of<br />

the kidneys. In the supine position at quiet breathing, the upper poles of the kidneys usually lie in front of the 12th ribs.<br />

48

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