Diagnostic ultrasound ( PDFDrive )

CHAPTER 9 The Kidney and Urinary Tract 315
A
B
C
D
E
F
FIG. 9.6 Hypertrophied Column of Bertin. (A) Sagittal and (B) transverse sonograms show classic appearance of the column of Bertin.
(C) Medullary pyramids can be seen within the hypertrophied column of Bertin. (D) Echogenicity of the column may vary based on orientation.
(E) Transverse sonogram and (F) corresponding power Doppler image conirm a hypertrophied column.
voiding or insertion of a Foley catheter will clarify the location
and appearance of the bladder relative to the luid-illed mass.
Incomplete bladder emptying can be due to prostate enlargement,
neurogenic bladder, or pelvic loor weakness. Bladder
stones and infection are important complications. Initial assessment
includes assessment of the kidneys and ureter for dilatation,
as well as calculation of both a prevoid and postvoid residual.
We typically calculate bladder volume by taking the three
orthogonal measurements and multiplying by .6 (this is diferent
from most organs, which multiply by .52). his slightly larger
value is because the shape of the bladder is more of a cuboidal
shape than a prolate ellipse.
he urethra in a woman can be scanned with transvaginal,
transperineal, or translabial sonography 11 (Fig. 9.7). he posterior
or the prostatic urethra in men is best visualized with transrectal
probes (Fig. 9.8).