Diagnostic ultrasound ( PDFDrive )

CHAPTER 52 The Pediatric Urinary Tract and Adrenal Glands 1821
A
B
C
D
FIG. 52.65 Mesoblastic Nephroma. (A) and (B) Longitudinal and transverse gray-scale images of the right kidney depict a mass with peripheral
cysts (*) and a centrally located, heterogeneous zone surrounded by luid (arrows). Incidental echogenic renal pyramids due to medullary nephrocalcinosis
(arrowheads). (C) Transverse color Doppler image shows no low within the heterogeneous central portion of the tumor typical of cystic
necrosis or resolving hemorrhage. (D) Coronal intravenous contrast-enhanced computed tomography image demonstrates a large right renal mass
with little contrast enhancement compared with the adjacent compressed renal parenchyma (arrows), a relatively low-attenuating central zone (C),
and peripheral cysts (*).
A
B
FIG. 52.66 Renal Cell Carcinoma. Eleven-year-old girl with prior history of medulloblastoma. Renal tumor detected incidentally during surveillance
imaging. (A) Longitudinal gray-scale image reveals a round mass in the renal sinus (arrows) that contains multiple tiny calciications. (B) Longitudinal
color Doppler image shows peripheral displacement of the renal hilar vessels around the mass.
there is decreased sonographic diferentiation between the cortex
and medulla. 215,216
Longitudinal and transverse images of the adrenal gland are
best obtained with a high-frequency convex or sector transducer.
From the transverse images of the gland, AP and transverse
dimensions are measured. From the longitudinal images, the
cephalocaudal length is measured from the apex to the midpoint
of the base of the gland (Fig. 52.71).
If there is renal agenesis or ectopia, the neonatal gland will
appear lattened and “lying down” along the psoas muscle on