Nephroblastomatosis: comparison of CT with US and urography.
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Abstract:
A review of the imaging studies of five children with Wilms tumor and nephroblastomatosis demonstrated that contrast-enhanced computed tomography (CT) can show the multifocal involvement of nephroblastomatosis more accurately than either excretory urography or real-time ultrasound (US). In all five children, CT demonstrated multiple areas of nephroblastomatosis along the renal cortex. US showed a single intrarenal mass in each child (one bilaterally) but did not show the cortical nephroblastomatosis. Excretory urography also demonstrated only the dominant mass of the Wilms tumor. The superiority of CT is attributed to better spatial resolution and soft-tissue contrast differentiation and clear demarcation between nonenhanced nephroblastomatosis and enhanced normal renal parenchyma. Contrast-enhanced CT is therefore recommended for the evaluation of clinically abnormal and contralateral kidneys in all children with suspected Wilms tumor.Keywords:
Pyelogram
Renal parenchyma
Renal cortex
Parenchyma
In 195 with no manifest urinary tract disease, of me one to seven years of age, the ultrasound was used to determine the renal parenchyma (thickness at the gender inter-gender levels); their correlation with age the kidney dimensions was examined. The dynamic ratio between the parenchyma dimensions and those of the kidney was analyzed. The real-time mechanical sector scanner (ALOKA SSD 500) was used with convex probes of 3,5 and 5 MHz in the supine position and in the counter-lateral body decubitus. The parenchyma dimensions kept on increasing continuously during the analyzed period, most intensely in the second and fifth years of age. The parenchyma enlargement was in a better con-elation with the kidney growth than with the children's age. Still, there is an evident slight enlargement of the parenchyma dimensions than that of the kidney dimensions.
Parenchyma
Supine position
Renal parenchyma
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Computed tomography was performed before and after telelithotripsy to evaluate changes in renal parenchyma induced by the procedure in 34 patients with nephroliths. Piezolith-2300 lithotriptor ("Wolf", FRG) was employed. The images showed no serious parenchymal injuries or paranephric hematomas, on the one hand, but density changes in the parenchyma, on the other hand. These were of 3 types: focal reduction in 3, diffuse reduction in 4 and diffuse increase of the density in 2 patients. As shown by comparison with literature data, telelithotripsy on "Piezolith-2300" causes minimal changes in renal parenchyma and perirenal fat. In view of this, the procedure is recommended for wide clinical and outpatient practice.
Parenchyma
Renal parenchyma
Liver parenchyma
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A method for estimating the renal parenchyma relative to the whole kidney (renal parenchymal index, RPI) by ultrasonography has been developed. This method (the area of the sinus relative to the area of the whole kidney) was applied to sets of renal diseases. Hydronephrosis and fibrolipomatosis lead to enlargement of the renal sinus area. Changes in the proportion of parenchyma are small in chronic parenchymal diseases, but it often increases in thickness in acute cases and the RPI is consequently lower. The scars of chronic pyelonephritis reduce the size of the parenchyma in an irregular manner, and therefore measurement of the RPI is not as suitable in such cases as it is in other diseases, which involve generalized parenchymal changes. Because of the great normal variations the method is not suitable for diagnosis in single cases, but it is appropriate for basic surveys in which the relative changes in the renal parenchyma are being assessed in a large number of cases.
Parenchyma
Renal parenchyma
Renal sinus
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Objective: The objective of this study was to assess the sonographic findings in renal parenchymal diseases using gray-scale ultrasound in order to classify these diseases. The study design was a cross-sectional one. There were 204 patients who were suspected with renal diseases. They had been scanned with ultrasound to assess the kidneys. The echogenicity, renal cortex and paren-chyma, and cortico-medullary differentiation had been evaluated. Results: The study revealed that the echogenicity of renal parenchyma and cortex increased in all types of renal parenchymal diseases. The cortico-medullary differentiation was mainly disturbed in acute parenchymal disease (69.04%), loss in chronic end-stage parenchymal disease (85%); and there was significant difference (p-value = 0.0001). Conclusion: Ultrasound provided useful and accurate diagnosis of renal parenchymal diseases. In this study, renal parenchymal diseases had been classified into acute, chronic and end-stage renal parenchymal diseases.
Echogenicity
Parenchyma
Renal cortex
Renal parenchyma
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Parenchyma
Renal parenchyma
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Objective To study the relationship between renal morphology and renal function,and to assess the value of CT as a criterion to grade renal function.Methods Enhancement CT were performed in 89 patients with no local renal disease whose split renal glomerular filtration rates(GFR)were measured by renal dynamic imaging with ~(99)Tc~m-DTPA.The 178 kidneys were divided into normal renal function,mild and severe renal impairment groups according to renal function.Differences between three groups respect to the mean thickness of renal cortex and parenchyma were assessed by ANOVA.Using Pearson's correlation test,the correlation between the renal cortex,parenchyma thicknesses and renal GFR were examined.The value of CT in predicting renal function was assessed by using ROC analysis.Results The renal cortex thicknesses of normal renal function,mild and severe renal impairment groups were(5.9±1.1),(4.6± 1.1),and(3.3±1.0)mm respectively,and the renal parenchyma thicknesses were(26.3±4.2), (21.3±4.6),(16.2±4.6)mm.There were significant differences of renal cortex,parenchyma thicknesses between 3 groups(cortex F=54.78,P0.01;parenchyma F=43.90,P0.01).The thicknesses of renal cortex(r=0.752,P0.01),parenchyma(r=0.738,P0.01)had positive linear correlation with renal function.ROC analysis of the renal cortex thicknesses measured by CT in predicting mild and severe renal impairment showed that the Az was 0.860 and 0.905 respectively,whereas that of parenchyma was 0.868 and 0.884.Conclusion The thicknesses of renal cortex,parenchyma measured by CT can reflect renal function.CT was a supplementary method to assess renal function.
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Parenchyma
Renal parenchyma
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Parenchyma
Renal parenchyma
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Forty-three children with normal urograms and with kidneys of normal size regarding length, area and parenchymal thickness were examined using a water-delay computerized ultrasonographic equipment. Renal parenchymal volumes were calculated and related to body weight. The correlation coefficient was 0.92. The renal parenchymal volume of the left kidney was significantly larger than that of the right kidney (p<0.001). For practical purposes they should, however, be assumed to be of equal size, 2.0±0.3 cm 3 /kg body weight.
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Body surface area
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Pyelitis is an inflammation of the mucous membrane of the pelvis and calices of the kidney, whereas with pyelonephritis the process is more advanced; in addition to the changes in the pelvis and calices there is an infection of the parenchyma. Acute pyelitis as a distinct pathologic entity is not common, for it is usually associated with varying degrees of pyelonephritis. Pyelitis is usually secondary to infection in the parenchyma and in many cases this infection in the parenchyma clears up, leaving the pelvis and calices of the kidney involved. The differential diagnosis between simple pyelitis and pyelonephritis is impossible without the use of functional tests. Of course, in simple pyelitis there is no decrease in function, for the parenchyma is not involved, whereas in pyelonephritis there is a reduction in the output of dye. In cases in which the infection in the parenchyma has cleared up and with a
Parenchyma
Renal parenchyma
Clearance
Renal pelvis
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