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Full Description
Renal sonography forms a basic part of routine diagnostic strategy. This textbook summarizes eighteen years of experience in diagnostic ultrasound. We want it to serve as a guide to both imagers and mere consumers of information. That is why we shall emphasize practical advice and diagnostic pitfalls; it is also why we shall often deal with the relations of sonography with other diagnostic procedures, which it may complement or replace, precede or follow, the purpose being to achieve efficiency at low cost. We shall limit our subject matter to the kidney itself and the neighboring retroperitoneal compartments, dealing only briefly with the lower urinary tract, which requires specialized procedures. We devoted considerable space to renal sonography in our book Clinical Atlas of Ultrasonic Radiography, published in 1973. Since then, nothing has changed and everything has changed. Nothing, because even then the differential diagnosis between a solid and a cystic mass, the etiologic diagnosis of a nonsecreting kidney, and the positive diagnosis of a traumatic juxtarenal hematoma were quite reliable, making possible drastic reductions in the indications for instrumental roentgenologic examinations. Everything, be cause improved resolution and grey scale imaging (already partially achieved in 1973, thanks to real time) have profoundly refined both anatomic and pathologic ultrasonic studies. And now high resolution real time imaging has revolutionized renal examination techniques, whereas Doppler is entering routine ultrasonic diagnosis.
Contents
1 Echoanatomy: Tissue Echopatterns.- 1.1 The Kidney Itself.- 1.2 The Kidney as a Part of the Retroperitoneal Compartment.- 1.3 Less Direct Renal Relationships.- 1.4 Basic Tissue Echopatterns: Pitfalls and Artifacts.- 2 Examination Techniques.- 2.1 Technical Data.- 2.2 Technological Prospects.- 2.3 Technical Factors of Image Quality.- 2.4 Positioning and Scanning Directions.- 2.5 Particular Problems.- 2.6 General Management of Ultrasonic Examinations.- 3 Hydronephrosis.- 3.1 Beginning Hydronephrosis.- 3.2 Frank Hydronephrosis.- 3.3 Major Hydronephrosis.- 3.4 Differential Diagnosis.- 3.5 Ureteral Dilatation.- 3.6 Complementary Pelvic Examination.- 3.7 Renal Lithiasis.- 4 Renal Cysts.- The Renal Cystic Pattern.- 4.1 Benign Cysts.- 4.2 Polycystic Processes.- 5 Renal Tumors.- 5.1 Malignant Tumors.- 5.2 Benign Tumors.- 5.3 Differential Diagnosis.- 6 Evaluation of Tumoral Spread: The Retroperitoneal Space.- 6.1 Direct Spread.- 6.2 Lymphatic Spread.- 6.3 Intracaval Extension.- 6.4 Metastatic Spread.- 6.5 Clinical and Radiological Policy.- 6.6 Particular Cases.- 7 Infections and Inflammatory Processes.- 7.1 Abscesses.- 7.2 Bacterial Nephritides.- 7.3 Pyonephrosis.- 7.4 Tuberculosis.- 7.5 Differential Diagnosis of Chronic Inflammatory Processes.- 7.6 Chronic Pyelonephritis.- 7.7 Nephrocalcinosis, Papillary Necrosis, and Cortical Necrosis.- 7.9 Postnephrectomy Abscesses.- 8 Hunchbacks, Dwarfs, and Giants.- 8.1 Horseshoe Kidneys.- 8.2 Miscellaneous Anomalies.- 8.3 Absence of Kidney; Ectopic Kidneys.- 8.4 Renal Hypoplasia.- 8.5 Nephromegaly.- 8.6 Abnormalities of Vascular Origin.- 8.7 The Transplanted Kidney.- 8.8 Ultrasound in Renal Failure — Anuria.- 9 Ultrasonic Differential Diagnosis and Diagnostic Policies: Synopsis.- 10 Renal Trauma and Juxtarenal Collections, Traumatic andNontraumatic.- 10.1 Examination Procedure in the Traumatized Patients.- 10.2 Renal Lesions.- 10.3 Juxtarenal Abnormalities.- 10.4 Traumatic Urinomas (Uriniferous Cysts) and Nontraumatic.- 10.5 Associated Lesions.- 10.6 Radiological Policy.- 11 Adrenals.- 11.1 The Normal Adrenal.- 11.2 The Pathological Adrenal.- 11.3 Diagnosis.- 11.4 Reliability and Diagnostic Policy.- 12 Lower Urinary Tract.- 12.1 Bladder.- 12.2 Prostate.- 12.3 Testis and Its Covering.- References.
