Ultrasound of the Kidneys

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Presentation transcript:

Ultrasound of the Kidneys Wendy Blount, DVM Click on the blue arrow at bottom left or hit the “return” key to advance the show (mouse over to reveal) Free PowerPoint Templates

Transition Adjustments Depth – relatively superficial on the right, left varies Frequency – varies 5-7.5 MHz (higher for smaller pets) deeper penetration for large dogs comes at the expense of detail May need lower frequency than bladder and gut Gain and Contrast – usually no change from liver & spleen TGC – adjust as needed Free PowerPoint Templates

Landmarks for Kidneys Left Kidney – location variable – caudal to left costal arch Spleen serves as an acoustic window Caudal to the stomach Dorsal and medial to the spleen, caudal to the spleen head Right Kidney - usually cranial & dorsal to the left kidney Follow the caudate lobe of the liver caudally until you find it Or start at the dorsal aspect of the right costal arch, rocking the probe cranially Caudal to pylorus & liver, adjacent to the duodenum Free PowerPoint Templates

Landmarks for Kidneys Left Kidney – location variable Spleen serves as an acoustic window Caudal to the stomach Dorsal and medial to the spleen Right Kidney - usually cranial & dorsal to the left kidney Follow the caudate lobe of the liver caudally until you find it Or start at the dorsal aspect of the right costal arch, rocking the probe cranially Caudal to pylorus & liver, adjacent to the duodenum Free PowerPoint Templates

Landmarks for Kidneys Left Kidney – location variable Spleen serves as an acoustic window Caudal to the stomach Dorsal and medial to the spleen Right Kidney - usually cranial & dorsal to the left kidney Follow the caudate lobe of the liver caudally until you find it Or start at the dorsal aspect of the right costal arch, rocking the probe cranially Caudal to pylorus & liver, adjacent to the duodenum Free PowerPoint Templates

Landmarks for Kidneys Left Kidney – location variable Spleen serves as an acoustic window Caudal to the stomach Dorsal and medial to the spleen Right Kidney - usually cranial & dorsal to the left kidney Follow the caudate lobe of the liver caudally until you find it Or start at the dorsal aspect of the right costal arch, pointing the probe cranially Caudal to pylorus & liver, adjacent to the duodenum Free PowerPoint Templates

Landmarks for Kidneys Left Kidney – location variable Spleen serves as an acoustic window Caudal to the stomach Dorsal and medial to the spleen Right Kidney - usually cranial & dorsal to the left kidney Follow the caudate lobe of the liver caudally until you find it Or start at the dorsal aspect of the right costal arch, pointing the probe cranially Caudal to pylorus & liver, adjacent to the duodenum Free PowerPoint Templates

Image Views Sagittal Views (4 for each kidney) Medial– “Dumbbell View” Mid-Sagittal, Fan Medial - Renal Sinus & Pelvis Mid-Sagittal, Fan Lateral – “Tomato View” Lateral Transverse Views (3 for each kidney) Cranial Pole Mid-Transverse - Renal Sinus & Pelvis (renal pyramid/crest) Caudal Pole Free PowerPoint Templates

Image Views Sagittal Views (4 for each kidney) Medial– “Dumbbell View” Mid-Sagittal, Fan Medial - Renal Sinus & Pelvis Mid-Sagittal, Fan Lateral – “Tomato View” Lateral Transverse Views (3 for each kidney) Cranial Pole Mid-Transverse - Renal Sinus & Pelvis (renal pyramid/crest) Caudal Pole Free PowerPoint Templates

Scanning Left Kidney Sagittal Views Medial “Dumbbell View”

Scanning Left Kidney Sagittal Views Medial “Dumbbell View”

Scanning Left Kidney Sagittal Views Medial “Dumbbell View”

Scanning Left Kidney Sagittal Views Medial “Dumbbell View”

Scanning Left Kidney Sagittal Views LK Medial “Dumbbell View”

Mid-Sagittal – Fan Medial Scanning Left Kidney Sagittal Views Mid-Sagittal – Fan Medial Renal Sinus & Pelvis

Mid-Sagittal – Fan Medial Scanning Left Kidney Sagittal Views Mid-Sagittal – Fan Medial Renal Sinus & Pelvis

Mid-Sagittal – Fan Medial Scanning Left Kidney Sagittal Views Mid-Sagittal – Fan Medial Renal Sinus & Pelvis Medial (renal sinus/pelvis)

Mid-Sagittal – Fan Lateral Scanning Left Kidney Sagittal Views Mid-Sagittal – Fan Lateral “Tomato View” Renal Diverticuli

Mid-Sagittal – Fan Lateral Scanning Left Kidney Sagittal Views Mid-Sagittal – Fan Lateral “Tomato View” Renal Diverticuli

Mid-Sagittal – Fan Lateral Scanning Left Kidney Sagittal Views Mid-Sagittal – Fan Lateral “Tomato View” Renal Diverticuli

Scanning Left Kidney Sagittal Views Lateral Cortex

Scanning Left Kidney Sagittal Views Lateral Cortex

Scanning Left Kidney Sagittal Views Lateral Cortex

Scanning Left Kidney Sagittal Views Lateral Cortex

Scanning Transverse Views Mid-Transverse Left Kidney “C” Renal Sinus & Pelvis

Scanning Transverse Views Mid-Transverse Left Kidney “C” Renal Sinus & Pelvis

Scanning Transverse Views Mid-Transverse Left Kidney “C” Renal Sinus & Pelvis

Scanning Transverse Views Mid-Transverse Left Kidney “C” Renal Sinus & Pelvis LK

Scanning Left Kidney Transverse Views Cranial Pole

Scanning Left Kidney Transverse Views Cranial Pole

Scanning Left Kidney Transverse Views Cranial Pole

Scanning Left Kidney Transverse Views Caudal Pole

Scanning Left Kidney Transverse Views Caudal Pole

Scanning Left Kidney Transverse Views Caudal Pole

Scanning Left Kidney Transverse Views Caudal Pole

Scanning Left Kidney Transverse Views Caudal Pole

Scanning Left Kidney Transverse Views Caudal Pole

Scanning Left Kidney Transverse Views Caudal Pole

Scanning Left Kidney Transverse Views Caudal Pole

Scanning the Mid-Abdomen (gut) will be covered in the next section

Scanning the Right Kidney Sagittal Views Medial “Dumbbell View”

Scanning the Right Kidney Sagittal Views Medial “Dumbbell View”

Scanning the Right Kidney Sagittal Views Medial “Dumbbell View”

Scanning the Right Kidney Sagittal Views Medial “Dumbbell View”

Sagittal Views Medial Scanning the Right Kidney “Dumbbell View” Medial (poles symmetrical)

Mid-Sagittal – Fan Medial Scanning the Right Kidney Sagittal Views Mid-Sagittal – Fan Medial Renal Sinus & Pelvis

Mid-Sagittal – Fan Medial Scanning the Right Kidney Sagittal Views Mid-Sagittal – Fan Medial Renal Sinus & Pelvis

Mid-Sagittal – Fan Medial Scanning the Right Kidney Sagittal Views Mid-Sagittal – Fan Medial Renal Sinus & Pelvis Medial (renal sinus/pelvis)

Mid-Sagittal – Fan Lateral Scanning the Right Kidney Sagittal Views Mid-Sagittal – Fan Lateral “Tomato View” Renal Diverticuli

Mid-Sagittal – Fan Lateral Scanning the Right Kidney Sagittal Views Mid-Sagittal – Fan Lateral “Tomato View” Renal Diverticuli

Mid-Sagittal – Fan Lateral Scanning the Right Kidney Sagittal Views RK Mid-Sagittal – Fan Lateral “Tomato View” Renal Diverticuli Mid sagittal

Scanning the Right Kidney Sagittal Views Lateral Cortex

Scanning the Right Kidney Sagittal Views Lateral Cortex

Scanning the Right Kidney Sagittal Views Lateral Cortex

Scanning the Right Kidney Sagittal Views Lateral Cortex

Transverse Views Mid-Transverse Scanning the Right Kidney Renal Sinus & Pelvis

Transverse Views Mid-Transverse Scanning the Right Kidney “Reverse C” Renal Sinus & Pelvis

Transverse Views Mid-Transverse Scanning the Right Kidney “Reverse C” Renal Sinus & Pelvis

Transverse Views Mid-Transverse Scanning the Right Kidney “Reverse C” Renal Sinus & Pelvis Mid (renal sinus/pelvis)

Scanning the Right Kidney Transverse Views Cranial Pole

Scanning the Right Kidney Transverse Views Cranial Pole

Transverse Views Cranial Pole Scanning the Right Kidney RK

Scanning the Right Kidney Transverse Views Caudal Pole

Scanning the Right Kidney Transverse Views Caudal Pole

Scanning the Right Kidney Transverse Views Caudal Pole

Scanning the Right Kidney Transverse Views Caudal Pole

Scanning the Right Kidney Transverse Views Caudal Pole

Scanning the Right Kidney Transverse Views Caudal Pole

Scanning the Right Kidney Transverse Views Caudal Pole

Scanning the Right Kidney Transverse Views RK Caudal Pole Caudal pole

Goals of Kidney Ultrasound Video Academy of Veterinary Imaging: dorsal recumbency http://academy.soundvet.com/education-portal/ Goals of Kidney Ultrasound Anatomy Size Symmetry Free PowerPoint Templates

Telemedicine Videos Left Kidney – Sagittal – Lateral to Medial Free PowerPoint Templates

Telemedicine Videos Left Kidney – Sagittal – Lateral to Medial Free PowerPoint Templates

Telemedicine Videos Left Kidney – Sagittal – Lateral to Medial Incomplete scan - medial and lateral Free PowerPoint Templates

Telemedicine Videos Left Kidney – Sagittal – Lateral to Medial Right Kidney – Sagittal – Medial to Lateral Free PowerPoint Templates

Telemedicine Videos Left Kidney – Sagittal – Lateral to Medial Right Kidney – Sagittal – Medial to Lateral Free PowerPoint Templates

Telemedicine Videos Left Kidney – Sagittal – Lateral to Medial Right Kidney – Sagittal – Medial to Lateral Incomplete scan- lateral and caudal Free PowerPoint Templates

Telemedicine Videos Left Kidney – Sagittal – Lateral to Medial Right Kidney – Sagittal – Medial to Lateral Interference from gas in duodenum Free PowerPoint Templates

Telemedicine Videos Left Kidney – Sagittal – Lateral to Medial Right Kidney – Sagittal – Medial to Lateral Transverse scan (R or L) – Cranial to Caudal Only if abnormal Free PowerPoint Templates

Telemedicine Videos Left Kidney – Sagittal – Lateral to Medial Right Kidney – Sagittal – Medial to Lateral Transverse scan (R or L) – Cranial to Caudal Only if abnormal Lack of gel and air in colon, and lack of gel Free PowerPoint Templates

Acknowledgments Stephanie Lisciandro, ACVIM (Internal Medicine) Chapter 5: Focused or COAST3 – Kidneys Focused Ultrasound Techniques for the Small Animal Practitioner Editor Greg Lisciandro Bob Cole, ACVR Auburn University The Academy of Veterinary Imaging 2409 Avenue J, Suite C Arlington, TX 76006 (800) 268-5354

Acknowledgments John Mattoon, Danelle Auld, Thomas Nyland Chapter 4: Abdominal Ultrasound Scanning Techniques Small Animal Diagnostic Ultrasound Editors Nyland and Mattoon – 3rd Edition 2014 Thomas Nyland, John Mattoon, Eric Herrgesell. Erik Wisner Chapter 9: Urinary Tract Small Animal Diagnostic Ultrasound Editors Nyland and Mattoon – 3rd Edition 2014 John P. Graham, MVB, MSc, DVR, MRCVS Diplomate, ECVDI, Diplomate, ACVR Diagnostic Imaging in Dogs and Cats Nestle Purina – Clinical Handbook Series