Diagnostic Ultrasound - Abdomen and Pelvis

Hyperechoic Kidney
Chronic Glomerular Diseases
HIV Nephropathy
(Left) Longitudinal ultrasound
after biopsy of the kidney is
shown. There is a very
echogenic kidney ſt with a
hypoechoic perinephric
hematoma which was
managed conservatively.
Biopsy revealed focal
glomerulosclerosis. The noisy
image results from diffuse
edema/nephrotic syndrome.
(Right) Longitudinal US of the
left kidney in a patient with
AIDS & renal failure is shown.
The left kidney ſt is small and
markedly increased in
echogenicity with pelviectasis
. There is a small amount of
ascites st.
Differential Diagnoses: Kidney
Emphysematous Pyelonephritis
Autosomal Recessive Polycystic Kidney
Disease
(Left) Longitudinal ultrasound
of a renal transplant shows
normal pyramids st in the
lower pole. In the upper pole,
there is an area of increased
echogenicity with
shadowing ſt representing
gas from segmental
emphysematous
pyelonephritis. (Right)
Longitudinal ultrasound of the
kidney in a neonate shows an
enlarged hyperechoic kidney
with innumerable tiny
cysts ſt. The other kidney was
the same.
Lithium Nephropathy
Ischemia
(Left) Longitudinal ultrasound
shows a hyperechoic right
kidney ſt with innumerable
tiny echogenic nonshadowing
foci st representing
microcysts. A larger cyst
was also present. (Right)
Longitudinal ultrasound of a
renal transplant shows
hyperechoic wedge-shaped
cortical lesions ſt. Multiple
cortical infarcts were found on
biopsy.
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