Fetal-urogenital

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Ultrasound images of diseases of fetal urogenital system:

 

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1) Fetal hydronephrosis:

 

Hydronephrosis of left fetal kidney     Note the dilated calyces

Both fetal kidneys shown for comparison     Thinning of the renal parenchyma

These ultrasound images reveal unilateral hydronephrosis of the left fetal kidney. The renal pelvis and calyces appear dilated with thinning of the renal parenchyma in the affected kidney. The commonest cause of such hydronephrosis is PUJ (Pelvi-ureteral junctional) obstruction, usually functional. The left ureter does not appear to be dilated. For cases of dilatation of the renal pelvis, it is labelled as abnormal if the RPD (renal pelvic A-P diameter) is more than 10mm (after 20 weeks gestational age). If less than 20 weeks, more than 4mm. is abnormal. Images courtesy of Dr. Arun Mahajan, Delhi, India.

 

2) Fetal polycystic kidneys (autosomal recessive polycystic kidney disease- ARPKD):

Case 1:

ultrasound image of fetal autosomal recessive polycystic kidney

Sonography of the fetal abdomen in this 2nd trimester fetus reveals- 1) bilateral grossly enlarged fetal kidneys, almost filling the entire abdomen 2) markedly hyperechoic fetal kidneys with minute anechoic areas within them.        3) oligohydramnios 4) poorly distended urinary bladder. This ultrasound image is diagnostic of fetal polycystic kidney disease (ARPKD). This image was taken by Dr. Durr-e-Sabih, Pakistan, using a Toshiba Nemio-30 color doppler machine.

 

Sonography of another case of infantile polycystic kidney disease (autosomal recessive polycystic kidney disease) or ARPKD: Case 2:

ultrasound image showing enlarged hyperechoic fetal kidneys     ultrasound image of infantile polycystic kidney disease

These ultrasound images (another case) also show grossly enlarged, echogenic fetal kidneys with minute cystic lesions (1 to 2 mm.) within them. The cystic lesions in this case, as well as the previous case show a typical rosette like pattern that is typical of autosomal recessive polycystic kidney disease. These ultrasound images are courtesy of Dr. Jaydeep Gandhi, Mumbai India. The machine used is  a Nemio 30 from Toshiba.

Reference: E-medicine article on ARPKD

                http://www.jultrasoundmed.org/cgi/reprint/22/1/105.pdf (free article and images).

Fetal simple renal cyst:

 

Solitary cyst of fetal kidney:

cystic structure seen in left kidney of fetus      left renal cyst in fetus

ultrasound image of simple renal cyst in fetus      3-D ultrasound image of renal cyst

This fetus of 30 weeks gestational age underwent sonography of the fetal abdomen. Ultrasound images show a small anechoic rounded lesion of the lower pole. The walls of the lesion are smooth and the contents appear to be clear fluid with no septae or tissue. There is also evidence of posterior acoustic enhancement. These ultrasound findings (images) are diagnostic of simple renal cyst (left kidney). Solitary renal cysts in fetus are a rare occurrence and may be of little clinical importance, but need to followed by serial scans for changes in characteristics or size. The lower right shows a 3-D ultrasound image of the fetal renal cyst. All images are courtesy of Ravi Kadasne, MD, UAE.

Reference: http://www.thefetus.net/page.php?id=547  (free article and images).

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3) Posterior urethral valve:

ultrasound image posterior urethral valve      distended fetal bladder and hydronephrotic kidney

keyhole bladder in fetus     sonography of posterior urethral valve

Sonography of this 3rd trimester fetus shows 1) keyhole urinary bladder (an overdistended bladder with the dilated prostatic urethra forming a keyhole like appearance). 2) hydronephrotic kidneys (bilateral) with thinning of the renal cortex. These ultrasound images suggest fetal lower urinary tract obstruction, probably a posterior urethral valve. Some degree of pelvi-ureteric junction obstruction may also be present. Images by Joe Antony, MD, India. Images taken using a GE- Logic 3 ultrasound machine.

4) Fetal ureterocele:

 

A rare case of ureterocele detected sonographically in 3rd trimester fetus:

ureterocele in fetus

Sonography of the fetal urinary bladder, shows a sac like structure (arrow) in the region of the distal end of the fetal left ureter. This ultrasound image suggests fetal ureterocele. Ureterocele is often seen in adults, but very rarely in a fetus. It is caused by defect during in embryogenesis of the fetal ureter. Ultrasound image is courtesy of Dr. Latha Natarajan, India.

Reference: http://www.thefetus.net/page.php?id=561 (free article and images)

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  This page was last edited on: Thursday December 17, 2009 01:31 PM  

Copyright ©   2007- All rights reserved- www.ultrasound-images.com Dr. Joe Antony, MD, Cochin- 20, India.

Scan centre: ULTRASCAN CENTRE, AL-FIA Building, Opp. Reserve Bank of India, ERNAKULAM,

COCHIN (KOCHI)- 682018, KERALA.

Ph: (Off.) 91-484-2403058, (Residence) 91-484-2311416, (Cell) 91- 93886-23088

Contact: joe@ultrasound-images.com or drjoea (at) gmail.com