Ultrasonography of the kidneys. The size of the kidneys on ultrasound in children and adults. How is a kidney ultrasound done?

Ultrasound examination in diseases of the urinary system is an important diagnostic measure. What does preparation for an ultrasound of the kidneys in women include? In our article you will find complete information on this issue.

Research using ultrasonic waves is widely used in medicine.

Main methods:

Sonography	The data obtained make it possible to assess the location of the kidneys, the state of the pyelocaliceal system and the parenchyma. Using this method, you can detect various anatomical defects and neoplasms of the excretory system.
dopplerography	Helps to identify circulatory disorders of the kidneys.

Advantages of ultrasound examination:

• safety;
• high information content;
• the procedure is well tolerated, does not cause side effects;
• affordable price;
• the study is painless, does not cause discomfort.

Important! During the procedure, no radioactive substances are used and there is no need to introduce X-ray contrast.

In what cases is ultrasound diagnostics necessary?

The kidneys are a parenchymal organ, so the pain syndrome often manifests itself only in the last stages of the disease. Cyclic changes in a woman's body can also affect the severity of symptoms.

Indications for ultrasound of the kidneys in women:

Complaints of aching pain in the lumbar region
Change (increase or decrease) in body temperature
Decrease in the volume of urine excreted (with the usual drinking regimen)
Swelling of the face or limbs in the morning and evening
Persistent increase in blood pressure, not amenable to medical correction

Similar symptoms are found in some diseases of the female genital area. Therefore, a complete ultrasound examination of the pelvic organs is necessary.

Additional indications:

• suspicion of congenital anomalies and prolapse of the kidneys;
• injuries of the lumbar region;
• metabolic disorders, accompanied by damage to the nephron (diabetes mellitus);
• detection of cancer, metastases;
• suspicion of;
• pathology of blood vessels;
• changes in urine and blood tests, indicating the pathology of the excretory system.

Before the examination

How to prepare for a kidney ultrasound for a woman?

Basic Rules:

Change your diet	The accumulation of a large amount of gas in the intestine makes it difficult to get a clear image. 2-3 days before the examination, it is necessary to exclude from the diet: pastry and fresh bread cooked with yeast; fruits and vegetables that lead to the activation of fermentation processes (apples, grapes, cabbage); cow's milk and products based on it; alcohol; fried fatty foods; legumes; carbonated drinks. Compliance with these simple rules will help eliminate diagnostic errors. buckwheat or oatmeal cooked in water; stale bread; lean boiled fish and meat. A planned ultrasound examination is carried out on an empty stomach, in the morning, after a hungry pause for 18-19 hours.
The fight against increased gas formation	Includes the following medications: activated charcoal (single dose - one tablet per 10 kg of weight); "Espumizan".
Empty your bowels	With a tendency to constipation: cleansing enema; a few days before the examination - taking laxatives.
Fill your bladder	This measure will help to more accurately determine the condition of the urinary tract. In order to make an ultrasound of the bladder in women, you need to drink 500 ml of non-carbonated pure water one hour before the study.

During the examination, a special gel is used. Take a towel with you to dry yourself after the diagnostic procedure.

Study

How is an ultrasound of the kidneys done in women?

Before the study, it is necessary to expose the abdomen and lumbar region. The examination is performed in different positions. First, the ureters are checked along their entire length, starting from the bladder, then the kidneys.

Contraindications:

• allergic to the gel that provides skin contact with the sensor;
• skin diseases;
• damage to the skin of the area under study (burns, boils, wounds).

Excess weight is an obstacle to research. Due to the large amount of subcutaneous adipose tissue, the image may be fuzzy.

Inspection steps:

The photos and videos in this article will tell you how an ultrasound examination is performed. Assessment of kidney mobility is carried out during inhalation and exhalation in various positions.

Ultrasound of the kidneys will help detect:

• dystrophic changes in the parenchyma;
• inflammatory process;
• benign and malignant neoplasms;
• abscesses and cysts;
• nephroptosis;
• pathological expansion or narrowing of the ureter;
• stones, sand;
• rejection of a transplanted kidney.

In order to make an echographic section of the kidney, the doctor installs the sensor in the middle part of the XII rib and directs the radiation at an angle of thirty degrees to the main axis of the body. This examination allows you to assess the anatomical features of the kidneys.

Evaluation of the results of the study

The ultrasound doctor sends the study data to the urologist for further interpretation.

Indicators of the condition of the kidneys:

During pregnancy, the load on the kidneys increases, and they become larger. An increase in length by two centimeters is considered normal, expansion of the pelvicalyceal system is possible.

After reading this article, you will receive complete information on how ultrasound of the kidneys is done.

Frequently asked questions to the doctor

Unfamiliar terms

Hello! Yesterday I had an ultrasound. In conclusion, it is written that intestinal pneumatosis is increased. What does it mean? They looked at my kidneys, what does the intestines have to do with it? Perhaps they discovered something terrible and are now hiding it?

Good afternoon A large amount of gas has accumulated in the intestines, which can distort the result of the examination. This record speaks of improper preparation for ultrasound, and not about the disease.

What affects dimensions?

Hello, Doctor! I have had only one kidney since birth. Yesterday I had a control ultrasound. The doctor said everything was fine. But I was embarrassed that all sizes are much larger than the norm (according to data from the Internet). I hadn't thought about it before, but now I decided to check it out. Worried! Tell me, what are the normal sizes of the kidneys of women?

Good afternoon The size of a single kidney will always be larger than usual, since the organ does double work.

Index	Norm	Pathology
Quantity	Two kidneys.	Agenesia (absence), hypoplasia or absence of a kidney).
The contour of the kidneys (its clarity and evenness is assessed)	Clear.	Fuzzy.
Sizes (same for men and women)	The normal size of the kidneys on ultrasound in women: thickness - from 40 to 50 mm; length - from 80 to 120 mm; width - from 45 to 70 mm.	A significant increase in the kidney is an indicator of the inflammatory process.
Position	The right kidney is located at the level of the XII thoracic and II lumbar vertebrae. The projection of the left is the level of the XI thoracic and I lumbar vertebrae.	Pathological prolapse of the kidney - nephroptosis.
Parenchyma (estimated its thickness and echogenicity by segments)	The normal thickness of the parenchyma is from 14 to 26 mm, in old age the parenchyma becomes thinner (10-11 mm).	Thickening is a sign of an inflammatory process or edema, thinning indicates dystrophy (a consequence of chronic diseases).
pelvicalyceal system	The normal size of the pelvis is up to 10 mm, during pregnancy a slight increase is permissible	Expansion of the renal pelvis is a sign of urinary outflow disorders (compression of the urinary tract during the formation of stones and a tumor process). Sometimes stones can be seen in the cavity of the pelvis.
The state of the renal blood flow	Physiological blood flow velocity is 50-150 cm/sec.	A decrease in blood flow is observed in women suffering from hypertension.

Conducting an ultrasound examination of people is the most accessible, informative and painless diagnostic method. Ultrasound is often used to diagnose pathologies of the urinary system. On ultrasound, the size of the kidney, its location, the structure of the renal tissue (parenchyma) and the functionality of both organs are determined. Any pathology is visible on an ultrasound examination in the form of increased or reduced echogenicity (intensity of the shade of organ tissues). It is by the strength of the reflection of ultrasound and by the change in the intensity of the darkening that the specialist issues a conclusion.

Important: deciphering the ultrasound of the kidneys is not yet an accurate diagnosis. To put it, the attending physician is obliged to compare all the data obtained in the form of an ultrasound protocol, laboratory blood and urine tests, and, if necessary, additional results of hardware diagnostics (CT, MRI, radiography, etc.).

Anatomy of the human kidney structure

It should be understood that, like all internal organs, the kidneys are supported by a musculoskeletal structure (CMS). That is why it is so important to have a well-developed and trained body, which will become a protective barrier for vital systems.

It should be understood that the size of the kidney of an adult and a child, as well as its structure, have a certain norm, and any deviations from it are considered a pathology. The kidneys normally have the following structure:

• View of the bean elongated along the form.
• From above, the organ is covered with connective tissue (fibrous capsule) and supported by a fatty capsule.
• Under the fibrous capsule is the parenchyma of the organ (its main tissue), which consists of the medulla and cortex. It is in the parenchyma that various formations in the form of cysts, abscesses, etc. are most often localized.
• One of the structural units of the kidney is the nephron, which is responsible for filtering the blood and processing waste materials into the primary urine.
• The renal pelvis is located inside the parenchyma and is designed to collect primary urine.
• The ureter is one of the parts of the organ that receives primary urine for its further transportation through the urinary tract.
• The renal artery is a vessel through which blood contaminated with decay products enters the kidneys.
• The renal vein is the vessel through which purified blood flows back into the vena cava.

The size of the kidneys is normal

It is worth knowing that the normal sizes of the kidneys in women and men, in an adult and a child are somewhat different and look something like this:

• The adult kidney has a length of 10-12 cm;
• Width - up to 6 cm;
• Thickness - 4-5 cm;
• The thickness of the parenchyma (kidney tissue) is 1.5-2.5 cm.

Children's kidney has sizes depending on age:

• Infant from birth to 2 months - 49 mm;
• Baby from 3 to 12 months - 63 mm;
• Child 1-5 years old - 72 mm;
• Child 5-10 years old - 85 mm;
• Teenager 10-15 years old - 98 mm;
• Young man 15-19 years old - 106 mm.

At the same time, to determine the exact size of the organ, the height and weight of the child is always taken into account. It is worth knowing that in newborns, the ratio of kidney size to body weight is three times greater than in an adult.

Factors affecting the change in the size of the kidneys

The size of the kidneys on ultrasound may differ slightly from the norm. Moreover, if these are deviations in one or all parameters at once within 1 cm, then there is no reason for concern. If the organ is enlarged by several centimeters in one or more parameters, then you need to look for a pathology. However, there are also permissible deviations in the greatness of the organs. Thus, the following has been proven:

• With ultrasound of the kidneys, the norm may be a unilateral increase in the urinary organ. That is, one kidney will be larger than the other. As a rule, this applies to the left. The right, in most cases, is 5% less than the left due to the effect of the liver on it. That is, the liver simply interferes with the normal growth of the kidney.
• It is also worth understanding that the normal size of the kidneys in men is somewhat different from the female urinary organs. That is, the kidneys of an adult male are larger. This is due to physiology - the male body is wider and larger than the female.
• Age also affects the size of the kidneys. So, human kidneys grow up to 20-25 years. After that, the paired organ remains in a stable size up to 50 years. And already with the age of 50+, the kidneys begin to decrease in size, but at the same time they do not lose their function.

Important: the thickness of the kidney parenchyma also depends on age. So, up to 50 years it is 1.5-2.5 cm, and later it decreases and by the age of 60 it is 1.1 cm.

Pathological changes in kidney parameters

In turn, a pathological change in the size of the urinary organs (increase or decrease due to illness) occurs for the following reasons:

• Nephrites in an acute form. Nephrites are called inflammatory processes that began as a secondary pathology after an infectious disease or developed primarily after an infection entered the urinary system through the urethra.
• Hydronephrosis. Or in a simple way, the overflow of the bowl / pelvis of the organ with urine. Such a pathology occurs if a patient has microcalculosis (the presence of kidney stones). When moving, the stone can block the ureter and then the outflow of urine will be difficult. Such a pathology requires urgent surgical intervention, otherwise the patient is threatened with rupture of the kidney and, as a result, blood poisoning.
• Oncology or benign education. As a rule, cysts can increase the volume of tissue when they grow. The same applies to malignant tumors.

A decrease in the size of the kidney occurs with such pathologies:

• Chronic course of nephritis. So, if the disease was not detected at the very beginning and at the same time it passed into the chronic phase, the kidney will gradually give up its position, which will lead to organ failure. As a result, a non-functioning organ will shrink.
• dystrophic processes. Such an anomaly in the conclusion of the ultrasound is called kidney dysplasia.

kidney hump

The parameters of the urinary organ can sometimes change not only in size, but also in contours. Sometimes the left kidney is characterized by the so-called hump, that is, the protrusion of the contour of the organ outward. Initially, a specialist can define this as a cyst or other formation, but upon closer examination and against the background of normal echogenicity, it becomes clear that this is just a feature of the organ. That is, a humpbacked kidney is only a feature of the anatomy of a particular patient. Such a structure does not bear any complications. The body performs its function completely and does not violate the image and quality of human life.

Parenchymal changes on ultrasound

When examining the kidneys on ultrasound, a specialist can identify not only deviations from normal sizes, but also violations in the structure of the kidney tissue. In conclusion, the terms "reduced echogenicity" or "increased echogenicity" will be introduced. That is, some parts of the parenchyma or its entire structure change under the influence of the current pathology. In most cases, it is in the parenchyma that cysts, formations, abscesses are localized. However, even an ultrasound specialist does not include the term “tumor” in the research protocol. An accurate diagnosis is made only by a doctor, based on laboratory tests performed earlier and on the results of additional hardware studies.

Changes in the pelvis

As a rule, the only changes that can occur with the pelvis are thickening of their mucosa or the presence of stones / sand in them. In the first case, the mucous membrane of the pelvis increases with acute pyelonephritis or hydronephrosis. That is, the mucous membrane is inflamed due to overflowing with urine with the inclusion of pathogenic bacteria. If stones were localized in the pelvis, then this also indicates inflammation of the mucosa. In this case, the pelvis will be expanded.

Important: stones smaller than 2 mm are not visible on ultrasound. Echogenicity differs only in stones of larger diameter.

Kidney normal on ultrasound

• Renal tissue is homogeneous;
• Contours - smooth;
• The pelvis is free from stones and sand.

Terms of ultrasound

If you really want to understand before the visit to the attending physician what the specialist wrote there in the conclusion, then we offer a number of special terms that will help you understand the results of the examination. So, the most commonly used are:

• echogenicity. This is the reaction of the tissues of the internal organs to the conducted ultrasound. Echogenicity is expressed in the intensity of tissue darkening.
• fibrous capsule. Tissue surrounding the kidney.
• Pelvis. Organ cavity in which primary urine is collected.
• Microcalculosis. The presence of sand or small stones in the pelvis.
• Parenchyma. Kidney tissue.
• Inclusions. The presence in the tissues of the body of any formations (cysts, etc.).

Important: but, even having an ultrasound report in your hands and understanding, you should not make a diagnosis yourself. This is done only by the attending physician, who has the right to suspect or exclude pathology according to the patient's medical history.

In most cases, ultrasound can be called a fully informative and sufficient diagnostic method in order to determine and prescribe adequate treatment, including the exclusion of pathologies during screening examinations. The price of ultrasound of the kidneys is quite acceptable, it must be specified in the registry of a medical institution.

An ultrasound device 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 stones in the cavities, as well as malignant or benign neoplasms.

What indicators are being studied?

• The number of kidneys.
• Organ sizes.
• Its localization.
• Shape and contours.
• structure of the renal parenchyma.
• blood flow condition.

Let's consider these parameters in more detail.

Quantity

In this article, we will understand how the decoding of ultrasound of the kidneys is carried out.

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 the kidney could be removed through surgery. You can also find congenital duplication of the organ, most often it is one-sided.

Location

The normal location of the kidneys can be called their being 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.

Ultrasound examination of the kidney in a woman helps to identify nephroptosis (omission) or dystopia, that is, its atypical location in the small 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. Normal sizes in pregnant women are different, since during this period the kidney is elongated by two centimeters. Also, a slight expansion of the pelvis and ureters is acceptable to them.

Sizes for adults

The physiological norm for 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 when deciphering renal ultrasound. The norm is 18-25 mm. However, this indicator depends on the age of the person. For the elderly, it may be reduced to 11 mm, which is associated with sclerotic changes. Parenchyma is a tissue in which 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 for children

An ultrasound scan is necessary for a newborn child if there is a high probability of abnormal development of his internal organs due to heredity, severe pregnancy and childbirth, changes in the baby's urine. Ultrasound of the kidneys for older children is prescribed after detecting abnormalities in the tests, with complaints of pain in the lower back or lower abdomen, due to injury, in violation of urination.

In children, the size of the kidneys depends on height and age. If the height is less than 80 cm, then only 2 parameters are measured: the width and length of the organ. In a child from 100 cm, they also measure the thickness of the parenchyma.

The kidneys increase in size with acute glomerulonephritis or pyelonephritis, as well as with the loss of pairing, since in this case the organ will experience an increased functional load.

When deciphering the ultrasound of the kidneys, the clear identification of the boundaries 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 the 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 brighter when the parenchyma is denser. In low-density tissues, echogenicity is weak, with visualization in the form of dark areas.

Air and fluids are anechoic. For example, a cavitary cyst containing fluid is described by a specialist as an anechoic formation. For sclerotic processes, on the contrary, hyperechogenicity is characteristic.

CSL

Or the cavitary 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 membrane of the pelvis). Also, the expansion of PCS may indicate calicoectasia, pyelectasis, tumors, ureteral obstruction and hydronephrosis.

The norm for the pelvicalyceal system is its anechoic. Stones, the size of which is 4-5 mm or more, are described in the ultrasound report as an echogenic formation, echogen. The presence of sand in the body is called microcalculosis.

renal blood flow

To visualize the blood vessels of an organ, duplex scanning is used, in which the 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 the kidneys in children. Ultrasound determines the condition of the walls of blood 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 accelerated blood flow is recorded in bright color, indicating the presence of stenosis, the main symptom of which is an increase in velocity in the renal artery (200 cm/sec). The blood flow resistance index is also determined, which depends directly on the age of the person. It is higher the older the patient. For the renal artery, the norm of the resistance index is 0.7, and for the interlobar arteries - 0.34-0.74.

Identification 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:

Deciphering the results

Which are given above, should be carried out by a urologist. The conclusion is usually accompanied by a sonogram or an attached ultrasound photo, on which arrows mark the place where pathological changes were detected. If an ultrasound video is attached when vascular changes or tumors are detected, this will help to make the correct diagnosis.

Abnormalities detected by ultrasound

The most informative is ultrasound diagnostics when detecting such diseases as damage to the renal vessels, nephroptosis, amyloidosis, organ degeneration, abscesses, cysts, tumors, hydronephrosis, stone formation, inflammatory processes (glomerulonephritis, pyelonephritis).

When “pronounced intestinal pneumatosis” is indicated in the ultrasound report, this 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 chosen 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 3500. 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.

In order for the ultrasound data of the kidneys to be as accurate as possible, a person needs to properly prepare, following the rules and instructions of the doctor. The purpose of the study is to identify the disease in adults and monitor the condition of the organ during pregnancy if a woman has complaints or symptoms. How does an ultrasound of an organ take place, what diseases and abnormalities can be determined, and what is an alternative way of diagnosing?

A number of suspicions of kidney disease will require a person to undergo an ultrasound procedure.

What is the purpose of the study and what does it show?

Ultrasound examination of a paired organ is a widely used diagnostic method that helps the doctor assess the degree of damage to the organ and other important criteria necessary for making a final diagnosis. Kidney disease is a common ailment that requires timely diagnosis and adequate treatment. With the help of ultrasound of the human kidneys, you can see the following anomalies:

• the development of inflammation;
• the presence of neoplasms of various etiologies;
• kidney size and location;
• state of the tissues of the body.

In the process of diagnosing kidney disease, the doctor receives enough information, while the method is safe, does not cause side effects, pain. Preparatory procedures do not require special efforts from the patient, the study does not last long. Ultrasound diagnostics does not involve the use of radiological exposure, so it is safely prescribed to pregnant women from the very beginning and to the smallest patients.

Ultrasound is a safe and informative method for examining the kidneys

The photo is black and white, based on which the doctor will be able to give a description of the disease. Before the examination, the doctor will give recommendations that will help you prepare properly.

Indications

An ultrasound examination of the kidneys is performed in the presence of such conditions:

• a person is constantly worried about swelling of the face and body, while he constantly feels unwell;
• blood pressure rises for no reason, while the attacks become chronic;
• in the region of the lumbar region there are painful sensations, periodically discomfort is felt during urination;
• if the person had a back injury;
• if there are many symptoms of a disease of the endocrine system;
• before surgery;
• during the period of pregnancy.

Preparation

Preparation for ultrasound of the abdominal cavity and kidneys does not require special recommendations and preparatory procedures from a person. An important point that can affect the results of the study and will not detect pathology is the presence of gases in the intestines. The ultrasound does not completely pass through the intestinal air, so the data will be distorted. A couple of days before the ultrasound of the kidneys and bladder, you need to give up products that contribute to gas formation. These are white cabbage, whole milk, chocolate, raw fruits and vegetables.

From medications, you need to drink activated charcoal or enterosorbents. Dinner on the eve of the day of the kidney ultrasound should be light. On the day of the ultrasound examination, you can have breakfast, but if the doctor prescribes an abdominal ultrasound, then eating is contraindicated. When examining the bladder, 40 minutes before the examination, drink up to half a liter of water so that the bladder can fill up.

Ultrasound of the kidney during pregnancy

Ultrasound of the kidneys during pregnancy is performed if the woman had kidney problems before conception or problems began to manifest themselves after the woman became pregnant. Therefore, it is important to conduct a complete diagnostic study of the whole organism before pregnancy, since after conception it is problematic to treat chronic diseases. Check the kidneys during pregnancy in such cases:

Ultrasound examination of the kidneys during pregnancy is carried out with pain in the lower back, injuries, negative urine tests.

• with pain in the lumbar region;
• if the urine test shows poor results;
• with the development of symptoms of infection of the genitourinary system;
• with injuries to the back and lower back.

If ultrasound of the kidneys is done in time, it will be possible to timely diagnose and begin treatment of such dangerous diseases as pyelonephritis, urolithiasis, kidney formation of various etiologies. Most often, inflammation occurs due to hormonal changes in the body, the growing uterus and fetus, and chronic diseases that have not been cured in a timely manner. Therefore, ultrasound of the kidneys and bladder is so important in the process of pregnancy, as it determines kidney disease and urea disease in the early stages, which is important for curing the disease.

Research types

In the process of diagnosis, two types of ultrasound are distinguished: echography and ultrasound dopplerography. Ultrasonography allows you to examine the structure of the tissues of the kidney, determine the location of the organ, its size, while the entire anatomy of the kidneys is visible. The data is transferred to the computer monitor, so the doctor sees the scan results in real time. This diagnostic method provides a lot of information, but it is impossible to identify the pathology of the renal blood flow.

Doppler ultrasound scanning of the kidneys reveals abnormalities in the functioning of the renal vessels. During the study, sound waves are reflected from red blood cells. In this case, the doctor evaluates the speed of blood flow, the structure of blood vessels and the presence of pathologies in them. The information is provided as a table with a graph showing the deviation from the norm. The doctor can determine if there are blood clots in the body or blockage of the veins, how narrowed they are.

Two types of ultrasound are used for diagnosis.

In addition to Doppler, color flow scanning is often used, in which the speed of blood flow is recorded in the form of colored stripes. The sonogram of the kidney and the obtained data are combined and the most accurate picture of the study is obtained.

How do they do it?

Before undergoing an ultrasound examination, the patient needs to remove clothes above the waist, lie down on the couch. Next, the laboratory assistant applies a gel to the skin of the abdomen and begins the diagnosis. The right kidney is examined with the patient lying on his back. The laboratory assistant will sometimes ask the person to hold his breath, while you need to relax as much as possible. The frontal section of the right kidney is done in the position on the left side.

To obtain an image of the left kidney, the transducer is moved to the left upper abdomen. It happens that profuse gas formation interferes with obtaining an image of the left kidney, so you need to try to scan the organ by asking the patient to roll over to the right side. A good image of the paired organ can be obtained in the standing position of the patient. The research technique is chosen by the doctor, having previously assessed the patient's condition and the severity of the disease.

Ultrasound with a contrast agent provides additional data on the health of neighboring organs of the kidneys.

In order for the nephrologist to be able to obtain a complete list of indicators and accurate images, the procedure must take place after preliminary preparation. If the patient is prescribed OBP, in which an ultrasound of the liver and spleen is done, the gallbladder and other abdominal organs are examined, then it is contraindicated to eat food that provokes increased gas formation. For 12 hours you can not eat food and drink a lot of liquid. This type of research will help to see the following data:

• the condition of the superficial tissues of the kidney;
• the thickness of the parenchyma of the organ, how the Bertini column is located, its height, whether the column has pathologies;
• the shape of the organ and urea;
• the presence of neoplasms and hypertrophy;
• other diseases of the abdominal organs (inflammation of the pancreas, spleen, gallbladder).

The kidneys will help to detect structural and anatomical changes in the urinary organs that are characteristic of a particular disease. The standards of indicators that are examined during the procedure differ in the norms for adults and children.

Ultrasound of the kidneys will help the doctor see such a standard set of indicators and parameters as:

• the number of organs;
• the location of the kidneys;
• dimensions;
• shape and contours;
• the structure of the renal parenchyma;
• blood flow condition.

Quantity

Normally, a person should have two kidneys, but there are also anomalies that may be associated with

• congenital absence;
• doubling of one of the organs;
• removal of the kidney due to surgery.

Location

The kidneys are located quite high, at the level of the first or second lumbar vertebra. Normally, the right kidney is located slightly higher than the left - this is due to the fact that it is pushed up by the liver. Too much lowered kidney is considered a deviation from the norm.

The location of the kidneys (view from the back)

Dimensions

For adults, the normal size of the kidneys is:

• length - 100-120 mm;
• width - 50-60 mm;
• thickness - 40-50 mm.

In children with:

• growth up to 80 cm - only the length and width are determined;
• height above 100 cm - all indicators are measured.

Inflammatory processes such as pyelonephritis or glomerulonephritis can increase the size of the kidneys and increase the risk of organ loss.

Shape and contours

The shape of a normal kidney is bean-shaped and has clear, even contours. In some cases, the “humped” or “lobed” kidney may also be the norm. Most often, these are congenital anomalies associated with abnormalities in the structure of the organ that do not require treatment, provided that the patient does not have any associated ailments.

It is also possible to identify such features of the body:

• uneven contours;
• change in shape, pelvis and cups;
• kink of the ureter.

Anatomically, the appearance of the kidneys resembles beans with slightly rounded poles, upper and lower

The structure of the renal parenchyma

Normally, the structure should be uniformly porous. If the kidneys are affected by the disease, then this parameter in the decoding of ultrasound can be described as “increased echogenicity” or “reduced echogenicity”.

In the parenchyma, cysts can occur - vesicles with liquid. They are not treated if they are small and do not change in size over time. If they cause symptoms or are outwardly unusual, a tumor may be present.

Blood flow status

A detailed diagnosis of blood vessels is most easily obtained using Doppler.

The Doppler ultrasound method allows you to determine:

• the state of the walls of blood vessels;
• the presence of stenosis and intravascular obstruction;
• blood flow velocity (normally from 50 to 150 cm/sec).

Visualization of renal blood flow. Dark tones are considered normal, bright colors are an increase in blood flow. This indicates the presence of stenosis, in which the blood flow velocity can reach 200 cm/sec.

Ultrasound indicators and their norms are described in the video. Provided by the channel "Clinic of Aesthetic Gynecology".

What does an ultrasound show and why is it done?

Ultrasound makes it possible to determine such pathologies as:

• formations on the kidneys (tumors benign and malignant);
• diffuse change or damage to the kidney parenchyma;
• urolithiasis (stone formation in the kidneys);
• nephroptosis (organ prolapse);
• inflammatory diseases, acute and chronic (pyelonephritis, as well as changes in glomerulonephritis);
• hydronephrosis;
• MKD (urolithic diathesis) of the kidneys;
• blockage of the ureters and expansion of the renal pelvis;
• congenital anomalies in the structure of the kidney and the circulatory system of an underdeveloped organ;
• cysts of various etiology and localization;
• pyelectasis in childhood;
• kidney abscesses;
• kidney tuberculosis.

It is possible to diagnose and recognize changes in the kidneys with the help of laboratory tests, but an ultrasound examination allows you to make an accurate diagnosis. It can be used to observe changes in the state of organs in dynamics, and the results obtained can be used during the pre- and postoperative period.

Norm indicators

For adults and for children, the ranges of indicators of the normal state of the kidneys are different. Differences between the indications of the norm in men and women were not revealed. Based on the special condition, in pregnant women, the norms differ from the usual ones.

In adults

The indicators of the norm in the structure of the kidneys in adults are shown in the table:

Height, cm	Length, mm	Length, mm	Width, mm	Width, mm	Parenchyma thickness, mm	Parenchyma thickness, mm
	Left	Right	Left	Right	Left	Right
150	85	82	33	29	13	13
160	92	90	35	33	14	13
180	105	100	38	37	17	15
200	110	105	43	41	18	17

In children

The norms for children are shown in the table:

Age	Right	Right	Right	Left	Left	Left
	Thickness, mm	Length, mm	Width, mm	Thickness, mm	Length, mm	Width, mm
1-2 months	18,0-29,5	39,0 — 68,9	15,9-31,5	13,6-30,2	40,0-71,0	15,9-31,0
3-6 months	19,1-30,3	45,6-70,0	18,2-31,8	19,0-30,6	47,0-72,0	17,2-31,0
1-3 years	20,4-31,6	54,7-82,3	20,9-35,3	21,2-34,0	55,6-84,8	19,2-36,4
up to 7 years	23,7-38,5	66,3-95,5	26,2-41,0	21,4-42,6	67,0-99,4	23,5-40,7

Permissible norms for pregnant women

If the results of ultrasound of pregnant women show that the organ is elongated up to 2 cm or there is a slight expansion (with pelvises and ureters), this is the norm.

What diseases are detected by ultrasound

Carrying out and decoding ultrasound of the kidneys will help to identify such diseases:

• inflammation of the bladder (cystitis);
• inflammation of the kidney (nephritis);
• inflammation of the renal pelvis (pyelonephritis);
• kidney cyst;
• salt, stones, sand in the kidneys and bladder;
• tumors;
• vascular disorders in the kidneys.

Traumatic injuries

Damage to the kidneys implies a violation of the integrity of the organ due to physical impact. It differs in severity: from mild injuries to those that threaten human life.

In medicine, two types of injuries are distinguished - closed and open injuries of the kidneys.

Closed damage

These include:

• contusion (there may be hemorrhages in the parenchyma, but there is no hematoma rupture);
• contusion;
• subcapsular rupture, with a hematoma present;
• crush;
• detachment of the ureter, complete or partial damage to the vascular pedicle (rupture of the tissue and fibrous capsule of the kidney).

Open damage

Causes of open damage can be:

• gunshot wounds;
• knife wounds;
• possible damage to the abdominal cavity with the subsequent development of peritonitis.

Photo gallery

Contusion (hematoma) of the kidney Kidney crush kidney injury

Deciphering the results of ultrasound of the kidneys

To decipher the indicators of ultrasound of the kidneys, it is better to contact a specialist who will also take into account the history of the patient's diseases as a whole.

Special terms in conclusion

In the conclusion of the ultrasound, there are special terms that are incomprehensible to most patients:

1. Severe pneumatosis of intestinal loops. This means that the study was difficult due to the large amount of gas in the intestines.
2. Pelvis. This is a small cavity in the middle of the kidney where urine collects. Urine from the renal pelvis enters the ureter, and from there it is completely excreted from the body.
3. Fibrous capsule - a membrane that covers the outside of the kidney. Normally, it should be even and clearly defined.
4. Echotenosis, hierechogenic inclusion, echogenic formation indicates the presence of stones or sand.
5. Microcalculosis of the kidneys means that small stones up to 5 mm or sand were found in the kidneys.

Signs of Healthy Kidneys

Signs of healthy abdominal organs:

• the shape of the kidneys is bean-shaped, the outlines of the organ are clear, there are no signs of changes in the urethra;
• aortic diameter is normal, no aneurysm;
• the abdominal organs are normal, there is no proliferation of tissue and fluid;
• the thickness of the gallbladder is normal, the ducts are not dilated, there are no stones;
• the liver is normal, the structure is not changed.

Pathological changes

The examination may show a deviation from the norm, therefore, in the conclusion of the ultrasound of the kidneys, the following description of the anomalies is indicated:

• the size of the organ is enlarged, the urination is disturbed, the ureters are dilated, there are kidney stones;
• the aorta is dilated, there are symptoms of an aneurysm;
• there are signs of inflammation, infection, disease;
• organs are displaced, tissues grow, or fluid is present in the abdominal cavity;
• the walls of the gallbladder are sealed, the ducts are dilated, stones are present;
• there are signs of geotomegaly, the structure of the organ is changed.

What do the colors on a kidney ultrasound mean?

In addition to blood flow, the structure of kidney tissue can also allow it to be visualized in color - this ability is called echogenicity.

Echogenicity of tissues and pathological formations on ultrasound:

Characteristics of the pathology

Description of how ultrasound will show the pathology in conclusion:

1. If the kidney is too mobile or its position is displaced, nephroptosis is diagnosed.
2. A wrinkled kidney speaks of nephrosclerosis.
3. Hyperechoic inclusions on ultrasound (darkening, darkening) look like neoplasms in the form of sand or stones. In this case, microcalculosis is diagnosed.
4. Neoplasms in the form of cysts or abscesses - a diagnosis of low echogenicity is made.
5. Seals, neoplasms in the form of tumors may indicate oncology or hemangioma of the kidneys. This pathology is usually diagnosed even when the tumor is in the organ bed. Kidney cancer can be more accurately identified with additional oncology tests.
6. Structural changes, uneven contours, enlarged kidneys or little mobility - the patient has pyelonephritis.
7. Uneven contours, increased echogenicity, reduced blood flow - kidney failure is diagnosed.
8. The thickness of the parenchyma decreases, there is no visualization of the hydronephrotic sac - typical for hydronephrosis.
9. If a decrease in the size of the kidneys is visible, the diagnosis is glomerulonephritis or the kidney is congenitally hypoplastic.
10. An increase in size indicates hydronephrosis, tumor processes, blood stasis.
11. An increase in the width of the renal pelvis is inflammation or signs of diseases of the urinary system.
12. A spongy kidney indicates a deformation of the renal canals - Malpighian pyramids, which are affected by many cysts.
13. A horseshoe-shaped kidney speaks of a congenital anomaly in the fusion of the two poles of the kidney to each other. In this case, a diagnosis is made of pyelonephritis, nephrolithiasis, hydronephrosis, or arterial hypertension.

Photo gallery

The photo clearly shows the pathology of the kidneys in the ultrasound images.

Video

The video clearly describes the anomalies of the kidneys in the course of their development. Provided by the channel "Petr Ivachev".