Tuesday, February 1, 2011

Hyperechoic fetal kidneys

This 22 week old fetus shows bilateral hyperechoic enlarged kidneys:
video 


The above ultrasound video clip shows a transverse section through the fetal kidneys. Observe the relative increase in echogenicity of the fetal kidneys, making it a little more echogenic than the adjacent fetal liver.
video  

 The above ultrasound video shows a good view of the left fetal kidney. The kidney is difficult to visualize due to its hyperechoic nature.
This color Doppler ultrasound video clip below shows relatively poor flow in the affected left fetal kidney (coronal section):
video  

video 
The above color Doppler ultrasound video clip shows the fetal right kidney, with similar features as the left kidney. Color Doppler brings out the kidney into better view, by showing the renal arteries.
  This lady also has another child with suspected autosomal recessive polycystic kidney disease (ARPCKD).
Here are some of the still ultrasound and color Doppler images of this same fetus:



















Clearly the images and ultrasound video clips above suggest a autosomal recessive polycystic kidney disease in this 22 week old fetus. No definite cystic areas are seen in the kidneys, but the other features are suggestive of this congenital disease of the kidneys. Observe the liqor and the urinary bladder (both appearing normal), suggesting that despite the serious nature of the renal disease, there is relatively normal kidney function at present.
See this link for more on this topic:
http://www.ultrasound-images.com/fetal-urogenital.htm#Fetal_polycystic_kidneys_%28autosomal_recessive_polycystic_kidney_disease-_ARPKD%29
You might also find these links useful: http://www.sonoworld.com/fetus/page.aspx?id=1519
                                                         http://radiographics.rsna.org/content/20/3/837.full