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Renal and Bladder Ultrasound

  • Angela B. CredittEmail author
  • Michael Joyce

Abstract

Point-of-care evaluation of the urinary system is focused on assessing the kidneys and bladder. Commonly, renal ultrasound is used to evaluate for hydronephrosis and/or evidence of renal stones in patients who present with signs and symptoms of nephrolithiasis. It is also frequently used to image the bladder to obtain measurements for calculating bladder volume in patients who report urinary retention. More recently, this ultrasound technique allows providers to evaluate for causes of gross hematuria and pain with indwelling catheter, for example. At times, incidental findings are noted, such as a bladder or renal mass, that will necessitate further management making it important to learn how to recognize these structures. This chapter will review the basic genitourinary anatomy, image acquisition, normal ultrasound anatomy, and interpretation of pathology.

Keywords

Hydronephrosis Kidney stone Renal cyst Bladder volume Bladder mass Enlarged prostate 

Supplementary material

Video 9.1

Right kidney in long axis: The right kidney is visualized next to the liver in long axis (MP4 1898 kb)

Video 9.2

Right kidney in short axis: In short axis, the right kidney will appear more rounded adjacent to the liver (MP4 1802 kb)

Video 9.3

Left kidney in long axis: The left kidney is visualized next to the spleen in long axis (MP4 1579 kb)

Video 9.4

Left kidney in short axis: Left kidney in short axis adjacent to the spleen (MP4 1550 kb)

Video 9.5

Bladder in transverse: Cross-sectional, or transverse, view of the bladder, scanning from superior to inferior (MP4 1762 kb)

Video 9.6

Bladder in sagittal: Sagittal view of the bladder (MP4 1814 kb)

Video 9.7

Ureteral flow jets: With high flow, ureteral flow jets can be seen entering the bladder with B-mode imaging (MP4 1763 kb)

Video 9.8

Ureteral flow jets with color Doppler: In a transverse plane, ureteral flow jets representing urine entering the bladder can be seen using color Doppler. (MP4 1775 kb)

Video 9.9

Mild hydronephrosis: Mild hydronephrosis of the left kidney (MP4 1861 kb)

Video 9.10

Moderate hydronephrosis: Moderate hydronephrosis of the kidney with hydroureter (MP4 2033 kb)

Video 9.11

Severe hydronephrosis: Complete distortion of the normal architecture due to severe dilation of the renal collecting system is seen with severe hydronephrosis (MP4 1959 kb)

Video 9.12

Hydroureter: Dilation of the ureter leaving the collecting system (MP4 1913 kb)

Video 9.13

Parenchymal stone: Stone within the renal parenchyma with posterior acoustic shadowing (MP4 2743 kb)

Video 9.14

Simple renal cyst: A large simple cyst as evidenced by a smooth, thin outer wall containing simple anechoic fluid with no internal echoes (MP4 1850 kb)

Video 9.15

Polycystic kidney disease: Multiple cysts of variable sizes that distort the architecture of the kidney suggesting polycystic kidney disease (MP4 1892 kb)

Video 9.16

Bladder mass: A large irregular bladder mass adjacent to the posterior wall of the bladder (MP4 1893 kb)

Video 9.17–

Bladder hematoma: Internal echoes in the correct setting represent blood within the bladder. A bladder hematoma can be easily confused with a bladder mass (MP4 480 kb)

Video 9.18

Enlarged prostate: Enlarged prostate with an abnormal and irregular shape that appears to extend into and distorts the bladder (MP4 1922 kb)

References

  1. 1.
    SonoSim Ultrasound Training Solution [Video]. Santa Monica, CA: SonoSim Inc.; 2017.Google Scholar
  2. 2.
    Patel U. Chapter 2: Imaging modalities used for assessment of the bladder. In: Patel U, editor. Imaging and urodynamics of the lower urinary tract. 2nd ed. Germany: Springer-Verlag London Limited; 2010. p. 9–21.CrossRefGoogle Scholar
  3. 3.
    Seif D, Swadron S. Chapter 12: Renal. In: Ma OJ, Mateer JR, Reardon RF, Joing SA, editors. Emergency ultrasound. 3rd ed. China: McGraw-Hill Education; 2014. p. 319–52.Google Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of Emergency MedicineVirginia Commonwealth University Medical CenterRichmondUSA

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