9%20ECOGRAFIA%20ABDOMINAL%20COMO%20CUANDO%20DONDE

164
ABDOMINAL ULTRASOUND
T
MRA
MRV
A
B
C
D
Figure 7.9 (A) The RK is almost completely replaced by a large renal carcinoma (T). The main renal vein contains
tumour thrombus which has spread into the IVC. The main renal artery is seen alongside. (B) Colour Doppler of the
tumour reveals vigorous, multidirectional blood flow within it. (C) Recurrence of carcinoma (between calipers) in the
right renal bed of a patient following right nephrectomy for renal carcinoma. (D) CT demonstrating a large left renal
carcinoma.
has well-defined borders whilst an RCC is illdefined:
differentiation may not be possible on all
occasions and biopsy or interval scan may be
required.
A chest X-ray and/or CT will demonstrate if
metastases are present in the lungs. Liver, adrenal
and lymph node metastases can be demonstrated
on ultrasound but CT is used for staging purposes
as ultrasound generally has a lower sensitivity for
distant disease detection.
Transitional cell carcinoma
Transitional cell carcinoma is the most common
bladder tumour, occurring less frequently in the collecting
system of the kidney and the ureter. It usually
presents with haematuria while still small. It is
best diagnosed with cystoscopy. Small tumours in
the collecting system are difficult to detect on ultrasound
unless there is proximal dilatation. Depending
on its location it may cause hydronephrosis,
particularly if it is situated in the ureter (rare) or at