Hematuria echocardiography and ultrasound: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Hematuria}} | {{Hematuria}} | ||
{{CMG}} ; {{AE}} {{Adnan Ezici}} | {{CMG}} ; {{AE}} {{Adnan Ezici}} , {{SCC}} , {{VSKP}} | ||
==Overview== | ==Overview== | ||
[[Ultrasound]] may be helpful in the diagnosis of the underlying etiology of hematuria. Ultrasound might be useful in detection of [[kidney stones]], [[renal cell carcinoma|renal malignancy]], and upper urinary tract malignancy. Findings on an ultrasound suggestive of kidney stones include echogenic foci, acoustic shadowing, twinkle artifact on color Doppler, color comet-tail artifact. | [[Ultrasound]] may be helpful in the diagnosis of the underlying etiology of hematuria. Ultrasound might be useful in detection of [[kidney stones]], [[renal cell carcinoma|renal malignancy]], and upper urinary tract malignancy. Ultrasound(US) offers an accurate, noninvasive approach to rule out [[obstructive uropathy]], determine renal size and cortical thickness, and look for masses or cysts. The availability of color duplex to assess renal vascular flow and resistance provides additional information regarding renal parenchyma. Findings on an ultrasound suggestive of kidney stones include echogenic foci, acoustic shadowing, twinkle artifact on color Doppler, color comet-tail artifact. | ||
==Ultrasound== | ==Ultrasound== | ||
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*Twinkle artifact on color Doppler | *Twinkle artifact on color Doppler | ||
*Color comet-tail artifact | *Color comet-tail artifact | ||
US is the first choice among the imaging studies to evaluate a patient with deterioration in [[renal]] function, because it does not involve the usage of [[nephrotoxic]] contrast media. US is the imaging test to consider in patients with suspected [[glomerular]] hematuria, as manifested by dysmorphic RBCs, proteinuria of at least 2+, and RBC casts. US is safe in pregnancy. It is less accurate in detecting ureteral lesions such as nonobstructing stones, and thus may not be the first choice for evaluating a suspected urological cause of hematuria.<ref>{{cite book | last = Rew | first = Karl | title = Primary care urology | publisher = Saunders | location = Philadelphia, Pa. London | year = 2010 | isbn = 978-1437724899 }}</ref> | |||
[[File:Renal-stone.png|thumb|center|5 mm renal stone detected by ultrasonography (USG). (Case courtesy of Dr Mohamed M. Yosef, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/63209">rID: 63209</a>)]] | |||
'''Advantages''' | |||
* Ultrasound of the abdomen and [[pelvis]] is safe.<ref name="Surgery (Oxford)">{{cite web |url=http://www.surgeryjournal.co.uk/article/S0263-9319(10)00199-7/abstract |title=www.surgeryjournal.co.uk |format= |work= |accessdate=}}</ref><ref name="pmid230987842">Davis R, Jones JS, Barocas DA, Castle EP, Lang EK, Leveillee RJ et al. (2012) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=23098784 Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline.] ''J Urol'' 188 (6 Suppl):2473-81. [http://dx.doi.org/10.1016/j.juro.2012.09.078 DOI:10.1016/j.juro.2012.09.078] PMID: [https://pubmed.gov/23098784 23098784]</ref> | |||
* US is good at: | |||
** Detecting renal parenchymal lesions (e.g. renal cell carcinoma) | |||
** Characterizing [[Renal cysts|renal cyst]] | |||
** Detecting renal calculi | |||
** Determining ureteric obstruction (Hydronephrosis) | |||
'''Disadvantages:''' | |||
* US is poor at detecting small lesions within the collecting system (e.g. urothelial cell carcinoma (UCC) of the renal pelvis) | |||
==References== | ==References== |
Latest revision as of 18:04, 16 September 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Adnan Ezici, M.D[2] , Steven C. Campbell, M.D., Ph.D. , Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [3]
Overview
Ultrasound may be helpful in the diagnosis of the underlying etiology of hematuria. Ultrasound might be useful in detection of kidney stones, renal malignancy, and upper urinary tract malignancy. Ultrasound(US) offers an accurate, noninvasive approach to rule out obstructive uropathy, determine renal size and cortical thickness, and look for masses or cysts. The availability of color duplex to assess renal vascular flow and resistance provides additional information regarding renal parenchyma. Findings on an ultrasound suggestive of kidney stones include echogenic foci, acoustic shadowing, twinkle artifact on color Doppler, color comet-tail artifact.
Ultrasound
Ultrasound may be helpful in the diagnosis of the underlying etiology of hematuria. Ultrasound might be useful in detection of kidney stones, renal malignancy, and upper urinary tract malignancy.[1] Findings on an ultrasound suggestive of kidney stones include:
- Echogenic foci
- Acoustic shadowing
- Twinkle artifact on color Doppler
- Color comet-tail artifact
US is the first choice among the imaging studies to evaluate a patient with deterioration in renal function, because it does not involve the usage of nephrotoxic contrast media. US is the imaging test to consider in patients with suspected glomerular hematuria, as manifested by dysmorphic RBCs, proteinuria of at least 2+, and RBC casts. US is safe in pregnancy. It is less accurate in detecting ureteral lesions such as nonobstructing stones, and thus may not be the first choice for evaluating a suspected urological cause of hematuria.[2]
Advantages
- Ultrasound of the abdomen and pelvis is safe.[3][4]
- US is good at:
- Detecting renal parenchymal lesions (e.g. renal cell carcinoma)
- Characterizing renal cyst
- Detecting renal calculi
- Determining ureteric obstruction (Hydronephrosis)
Disadvantages:
- US is poor at detecting small lesions within the collecting system (e.g. urothelial cell carcinoma (UCC) of the renal pelvis)
References
- ↑ Smith MR, Read KC, Stegman ML, Kroll NJ, Van Every MJ (November 2019). "Evaluation of Asymptomatic Microscopic Hematuria by Renal Ultrasound to Detect Upper Tract Malignancy: A 20-Year Experience in a Community Hospital". Urology. 133: 34–39. doi:10.1016/j.urology.2019.07.009. PMID 31310767.
- ↑ Rew, Karl (2010). Primary care urology. Philadelphia, Pa. London: Saunders. ISBN 978-1437724899.
- ↑ "www.surgeryjournal.co.uk".
- ↑ Davis R, Jones JS, Barocas DA, Castle EP, Lang EK, Leveillee RJ et al. (2012) Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline. J Urol 188 (6 Suppl):2473-81. DOI:10.1016/j.juro.2012.09.078 PMID: 23098784