In most cases, ultrasound can be called a fully informative and sufficient diagnostic method in order to determine kidney disease and prescribe adequate treatment, including eliminating pathology during screening examinations. The price of kidney ultrasound is quite acceptable, it must be clarified in the registry of a medical institution.
The apparatus for conducting ultrasound studies allows the doctor to determine several important parameters during the examination: the state of blood flow, the size of the organ, signs of inflammatory processes, the state of the structure of the parenchyma, the presence of calculi in the cavities, as well as malignant or benign neoplasms.
What indicators are examined?
- The number of kidneys.
- The size of the body.
- Its localization.
- Shape and contours.
- The structure of the renal parenchyma.
- Blood flow condition.
Consider these parameters in more detail.
number
In this article, we will figure out how to decipher an ultrasound of the kidneys.
The norm for a person is the presence of a pair of kidneys, but anomalies can also be found. There may be a congenital absence of one of them, the so-called agenesis (unilateral aplasia). Or they could have removed the kidney through surgery. You can also find congenital doubling of the organ, most often it is one-sided.
Location
The normal location of the kidneys can be called their location at different levels relative to each other. The right, D, is located at the level of the 2nd lumbar vertebra and the 12th thoracic, and the left, L, is located at the level of the 1st lumbar vertebra and the 11th thoracic.
An ultrasound examination of a woman’s kidney helps identify nephroptosis (prolapse) or dystopia, that is, its atypical location in the pelvis. The normal shape of the kidney is bean-shaped with a smooth contour and a clear view of the fibrous capsule, which is the outer shell of the organ. The sizes are normal in pregnant women, since during this period there is an extension of the kidney by two centimeters. Also, a small expansion of the pelvis and ureter is permissible for them.
Adult sizes
The physiological norm of the size of the kidneys in an adult is 40-50 mm in thickness, 50-60 mm in width, 100-120 mm in length. However, these figures may vary slightly depending on the gender and height of the patient.
The thickness of the parenchyma layer is another important parameter in decoding ultrasound of the kidneys. The norm is 18-25 mm. However, this indicator depends on the age of the person. For the elderly, it is possible to decrease it to 11 mm, which is associated with sclerotic changes. Parenchyma is the tissue in which the nephrons, structural and functional units, are located. If the indicator of its thickness increases, this may indicate inflammation or swelling of the organ, and if it decreases, then we can talk about its degeneration.
Sizes in children
Ultrasound is necessary for a newborn baby in case of a high probability of an abnormal development of internal organs due to heredity, severe pregnancy and childbirth, changes in the baby's urine. Ultrasound of the kidneys for children at an older age is prescribed after identifying deviations in the analysis, with complaints of pain in the lower back or lower abdomen, due to trauma, or urination problems.
In children, the size of the kidneys depends on height and age. If the growth is less than 80 cm, then only 2 parameters are measured: the width and length of the organ. In a child from 100 cm, in addition, the thickness of the parenchyma is measured.
The kidneys increase in size with acute glomerulonephritis or pyelonephritis, as well as with the loss of paired, because in this case the body will experience increased functional load.
When deciphering an ultrasound of the kidneys, a clear identification of the border of the pyramids of the parenchymal layer is considered the norm. Their echogenicity should be lower than that of the parenchyma. If such a difference is not found during the examination, this may indicate hydronephrosis.
Echogenicity of the parenchyma
This indicator determines the state and structure of renal tissue, which is normally homogeneous.
Echogenicity is the degree of intensity of reflection from the tissues of a sound wave. The reflection is more intense, and the image on the monitor is lighter when the parenchyma is denser. In low-density tissues, echogenicity is weak, with visualization in the form of dark patches.
Air and liquids are anechoic. For example, a cavity cyst containing fluid is described by a specialist as anechogenic formation. For sclerotic processes, on the contrary, hyperechoic is characteristic.
Csl
The pyelocaliceal system or abdominal system is responsible for performing the function of collecting urine. With the help of ultrasound of the kidneys in men, the following types of changes in it are diagnosed: the presence of calculi (sand, stones), pyelonephritis (inflammatory compaction of the mucous pelvis). Also, the expansion of the HF can indicate calicoectasia, pyeloectasia, tumors, ureter obstruction, and hydronephrosis.
The norm for the pyelocaliceal system is its anechogenicity. Stones, the size of which is 4-5 mm or more, in the conclusion of the ultrasound describe as an echogenic formation, hyperechoic inclusion, echogenicity. The presence of sand in an organ is called microcalculosis.
Renal blood flow
To visualize the blood vessels of an organ, duplex scanning is used, in which an ultrasound scanner provides information in a spectral graph or color image. This technique is painless and non-invasive. Therefore, it can be used when examining kidneys in children. Ultrasound determines the condition of the walls of the vessels, the presence of stenosis and intravascular obstruction, as well as the speed of blood flow. Its normal variation is from 50 to 150 cm / sec.
For the color scheme, dark tones are considered normal, and the accelerated blood flow is fixed in bright color, indicating the presence of stenosis, the main sign of which is an increase in the speed in the renal artery (200 cm / sec). The index of blood flow resistance, which depends directly on the person’s age, is also determined. He is the higher, the older the patient. For the renal artery, the norm index of the resistance index is 0.7, and for the interlobar arteries, 0.34-0.74.
Detection of pathological lesions
Ultrasound is also used to confirm kidney injury. There are 5 categories of injuries to this organ. They differ in the degree of violations:
- minimally damaged organ, no ruptures (detection of subcapsular kidney hematoma);
- the cortical substance is torn;
- the cortical substance is torn more than a centimeter, while the contrast ectravization is not observed;
- the ureteropelvic segment is broken;
- the vascular pedicle is damaged or it is torn off from the vessels and ureter.
Deciphering the results
The interpretation of the ultrasound of the kidneys, the norms of which are given above, should be carried out by a urologist. The conclusion is usually accompanied by a sonogram or an attached ultrasound photo, in which the arrows indicate the place where pathological changes are identified. If an ultrasound video is attached when detecting vascular changes or tumors, this will help to make a correct diagnosis.
Abnormalities detected by ultrasound
The most informative is ultrasound diagnostics when detecting diseases such as damage to the renal vessels, nephroptosis, amyloidosis, narrowing of the ureters, organ dystrophy, abscesses, cysts, tumors, hydronephrosis, stone formation, inflammatory processes (glomerulonephritis, pyelonephritis).
When ultrasound indicates "pronounced pneumatosis of the intestine" in the conclusion, it means that the examination was not informative due to flatulence. In this case, the ultrasound will need to be repeated, having previously prepared, that is, after drinking carminative drugs.
Ultrasound of the kidneys: price
The cost of this study depends entirely on the selected clinic and on the region. If you conduct an ultrasound in the direction of a doctor, then it can be free. In a private specialized center in Moscow, the average price ranges from 500 rubles to 3,500. In the regions, the cost will be slightly lower, but not significantly. You can pay for the study from 350 rubles to 2500.
From this article, you learned about ultrasound, about the norms of its indicators, as well as about kidney disorders that can be detected during the examination.