| Print Date: | May 24, 2013, 10:47 am |
| Title | Ultrasound renal anatomy |
| Text | NOTE: "Findings" and "Discussion" have identical text.
ULTRASOUND RENAL ANATOMY Transverse and longitudinal scans of the kidney can be performed by an anterior, coronal, or posterior approach. The anterior approach uses the acoustic windows of the liver on the right and the spleen on the left. These organs are less of a barrier to the ultrasound beam than the muscles of the back. The most commonly used approach is the coronal one, with the patient in the decubitus position. The right kidney is visualized through the intercostal spaces using the liver as an acoustic window. On the left, the spleen acts as a window to the kidney when the intercostal spaces are used. The best unit for this study is a sector type scanner with a wide angle and a small scanner face. However, complete evaluation of the kidneys may require a combination of these approaches. The lower amplitude reflections of the renal cortex can be distinguished from the echolucent renal pyramids. Occasionally, the arcuate vessels at the corticomedullary junction can be identified. The highly reflective fat of the renal sinus is located centrally within the kidney. Study the unlabeled images of the right kidney (Film 1) followed by the labeled images (Film 1A). Scan 1: Longitudinal scan through the right kidney. 1 - arcuate vessels at the corticomedullary junction c - renal cortex p - hypoechoic renal pyramid s - reflective fat in the renal sinus The renal vasculature, particularly the right renal artery, can be demonstrated with ultrasound. The left renal vein courses from the IVC, between the superior mesenteric artery and the aorta, to the left kidney. The right renal artery courses from the aorta, behind the inferior vena cava, to the right kidney. The vascular structures in the renal hila are oriented so that the renal vein is superior and anterior to the renal artery. Scan 2: Transverse supine scan. 2 - right renal artery (posterior to the inferior vena cava) a - aorta Look at Film 2 (unlabeled) and then Film 2A (labeled). Scans 1 and 2: Longitudinal supine scans, Scan 2 through the inferior vena cava. 3 - right renal artery Q - quadratus lumborum muscle The kidney sits on two large muscles. The lateral muscle is the quadratus lumborum, which stabilizes the lumbar spine and also stabilizes the diaphragm because of its attachment to the lower ribs. The medial muscle is the psoas muscle, which is a major hip flexor. Film 3 is unlabeled, followed by labeled Film 3A. They are from a male ballet dancer who has very prominent psoas muscles. Scan 1: Transverse scan of the right kidney. PS - psoas muscle Q - quadratus lumborum muscle Scan 2: Longitudinal scan of the left kidney. K - left kidney PS - psoas muscle SP - spleen |
| References: | |
| Contributor | Ultrasound Learning File - © ACR (ACR Learning File®) |
| Peer Reviewer | James G. Smirniotopoulos, M.D. (Uniformed Services University) |
| Record Number | : 1913 |
| Created | 2001-05-11 14:55:58-04 |
| Modified | 2004-06-08 19:13:03-04 |
| Category: | Anatomy, Normal and Measurements |
| Location: | Genitourinary |
| Sublocation: | Kidney |
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