Features of ultrasound imaging in renal parenchymal disease

**** The article will have four parts:

  • Some specialized English terms.
  • Pathology
  • Features of Diagnostic Imaging
  • For example

1. Some specialized English terms in the lesson:

Medical renal disease refer to a host of diseases that preeminent affect the renal parenchyma: Medical renal disease refers to a variety of diseases
mainly affects the renal parenchyma.

Renal parenchyma disease: Renal parenchymal disease

Chronic kidney disease (CKD): Chronic kidney disease.

Acquired cystic kidney disease (ACKD) is a condition that occurs in patients with end-stage renal disease (ESRD), especially when on dialysis treatment. They do not have a history of other cystic renal disease.

-> Acquired cystic kidney disease (ACKD) is a condition that occurs in patients with end-stage renal disease (ESRD), especially when the Patient has Renal Replacement Therapy (RRT) also called renal dialysis or just dialysis). The patient had no history of other renal cystic disease.

2. Pathology

Many different diseases can affect and damage the kidney parenchyma, the most common are:

Diabetes (diabetic kidney disease)



Polycystic kidney disease

3. Diagnostic Imaging Features

In the early stages of “Medical renal disease”the kidney may seem normal. Then changes in sound structure occur, but usually will not be specific for any cause.

There is no specific picture for CKD and diagnosis is based on clinical and laboratory findings. Imaging tests, especially ultrasound, are done in most cases to find the etiology (eg, renal artery stenosis, polycystic kidney disease, hydronephrosis) and to monitor treatment. .


Ultrasound with Doppler of intrarenal vessels is commonly performed in CKD patients, and is usually normal.

The typical B-mode ultrasound images of chronic (especially stage 5) severe chronic kidney disease are:

Decreased renal cortical thickness: <6 mm. (this indicator is more reliable than length)

  Specialized English lecture: Fatigue symptoms

Reduced kidney length.

Increased cortical echo***

QPoor observation of renal pyramids and renal sinuses

Renal border abnormalities

Renal pyramidal calcification

Nang (see also: Acquired cystic kidney disease (ACKD))

Abnormal Doppler findings in these patients are:

WOODdecreased renal blood vessels

Increased impedance index (RI) values ​​(segmental and interlobular arteries)

***Although increased echogenicity suggests parenchymal abnormality, the etiology cannot be determined. Hyperechoicity is when the right kidney echogenicity is higher than that of the liver or when The echogenicity of the left kidney is equal to or greater than that of the spleen. If renal-to-liver or spleen correlation images are not available, renal echogenicity is considered elevated if the renal pyramids abnormally low tone relative to the renal cortex. In In most cases, patients with renal parenchymal disease are examined for acute renal failure. In this case, it is not uncommon to see a small amount of fluid around the kidney and this will should not be misinterpreted as a sign of infection or injury (see Image. 573D). The main role of ultrasound in these patients is to rule out urinary tract obstruction and determine kidney size.

4. Example:

FIGURE 21-11. Chronic kidney disease, longitudinal plane. Right kidney (K) is small, size: 6 × 3 cm (pointer mark). Renal parenchyma (black arrows) is more hyperechoic (brighter) than the adjacent liver (L), inversion of the normal negative phenotype. This patient has chronic diabetic glomerulonephritis.

Renal parenchymal disease in different patients:

A, Longitudinal image of the right kidney (K) shows the right kidney slightly hyperechoic compared with the liver (L).
B, Cross-sectional image of the right kidney (K) shows a more hyperechoic kidney compared with
liver (L) due to acute tubular necrosis.
D, Longitudinal image of the left kidney (K) and spleen showing hyperechoic renal parenchyma and little perirenal fluid (arrow). Less perirenal fluid may be seen in the setting of acute renal failure.
C, Longitudinal view of the left kidney (K) shows The left kidney is more echogenic than the adjacent spleen (S) due to amyloidosis.

Follow along with other articles to foster more medical knowledge and medical English terms at homepage. Looking forward to everyone’s comments on the translation.

BS. Vo Thi Thanh Huong

Reference source:

Ultrasound The Requisites 3

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