Diagnostic Ultrasound - Abdomen and Pelvis

Dilated Renal Pelvis
Pyonephrosis
Pyonephrosis
(Left) Longitudinal ultrasound
of the right kidney
demonstrates low-level echoes
in the dilated renal pelvis
representing pyonephrosis.
Note urothelial thickening ſt,
an ancillary finding of urinary
tract infection. (Right)
Longitudinal color Doppler
ultrasound shows hypoechoic
tissue filling the dilated renal
collecting system with
internal color flow st
distinguishing this material as
neoplasm rather than
avascular pus or clot.
Differential Diagnoses: Kidney
Calyceal Diverticulum
Calyceal Diverticulum
(Left) Longitudinal ultrasound
demonstrates an anechoic
structure in the interpolar
region of the left kidney .
Given this image alone, one
might suspect pelviectasis or a
simple cyst. (Right) In this CT
obtained in the same patient,
however, one can appreciate a
small amount of layering
contrast within the lesion
on excretory phase
imaging, confirming calyceal
diverticulum.
Multilocular Cystic Nephroma
Multilocular Cystic Nephroma
(Left) Longitudinal ultrasound
demonstrates dilatation of the
renal pelvis , which contains
a cystic mass with thin internal
septa st. (Right) Coronal
contrast-enhanced T1-
weighted MR in the same
patient shows a mass
demonstrating septal
enhancement ſt entering the
renal pelvis. Histopathology
revealed multilocular cystic
nephroma.
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