Diseases of the urinary system in childhood are very common, and they do not have an age limit - both newborns and schoolchildren are equally susceptible to them. Ultrasound of the kidneys and bladder is considered one of the important diagnostic tools in pediatrics. We will talk about how such an examination is carried out, what it shows and how to prepare a child for diagnosis in this article.

About the study

Ultrasound of the kidneys and bladder is a non-invasive method for studying the condition of the urinary system. The features of the anatomical structure and functioning of the links of this system, naturally, cannot be fully assessed only through ultrasound, although such a diagnosis is considered quite complete and accurate. But ultrasound is an integral part of the examination, along with urine and blood tests, if the child has symptoms characteristic of urinary pathologies.

The procedure is completely painless, the child will not experience any discomfort.

Regarding the dangers of ultrasound examinations, medicine gives an official answer - the procedure is safe. Nevertheless, many parents are worried about the possible consequences of ultrasound exposure on the child’s body.

Indeed, not all consequences have been sufficiently studied to date. Modern medicine has had such a diagnostic tool only for the last 2.5 decades. To analyze the long-term consequences, much more time is needed. On the other hand, there is no data on the obvious or indirect negative effect of ultrasonic waves on the child’s body. Because of this, the procedure is considered safe.

The essence of the method is that ultrasonic waves from the sensor penetrate through tissue and are reflected, sending a response signal to the monitor as an image. Special computer program, which is in every ultrasound scanner, allows the doctor to quickly understand the size, amount of liquid, and other features, without resorting to complex mathematical calculations.

Ultrasound of the kidneys and bladder in a simplified form is included in the examination of the abdominal organs and is recommended by the Ministry of Health to all children as part of a preventive medical examination at 1 or 3 months, and then after a year. At any other time, such a study can be performed separately, without assessing other abdominal organs (stomach, spleen, liver, etc.) as indicated.

Also, specialists from the Ministry of Health have added this type of ultrasound to the medical examination program for children aged one and a half years. This is due to the fact that in Lately The number of children who are diagnosed with diseases of the kidneys, ureters, bladder and adrenal glands in an already advanced stage has increased significantly.

Indications

Sometimes mothers are surprised to receive a referral for such an ultrasound from a pediatric doctor when the child has no problems with urination. The study is not always indicated only for children with such pathologies. Quite often it is recommended for children who were born prematurely in order to assess the functioning of the system and exclude possible complications due to early birth. The study is also recommended for children whose parents suffer from diseases of the urinary system - quite often pathologies are inherited, but do not appear immediately.

In what other cases does a child need an ultrasound of the kidneys and bladder:

• when the color or amount of urine changes, or when an unpleasant, pungent odor appears;
• when crying during urination in newborns or infants or complaints of pain when emptying the bladder in older children;
• with a small amount of urine or, conversely, with increased diuresis;
• impurities are visible to the naked eye in the liquid - flakes, pus, blood;
• the child has anemia, pale skin, blue circles under the eyes;
• pain in the lower back, side;
• closed blunt abdominal injuries that a child can receive when falling on their stomach.

Also, an indisputable basis for prescribing such a diagnosis is a change in the composition of urine at the biochemical level.

If you and the child have no complaints, and the doctor considers the urine tests to be bad, he is obliged to send the child for an ultrasound scan of the kidneys and bladder to understand whether there are grounds for concern and treatment or whether there are no such grounds and a laboratory error occurred.

Preparation

Whether preliminary preparation for the study is needed is usually determined by the doctor who gave the referral. But even if the doctor forgot to tell the parents about this, the mother must remember like two times two - preparation is needed. And she must be very thorough. It determines how accurate the research results will be. It is necessary to prepare the child for the examination procedure in advance; preparation begins 2-3 days before the date of the visit to the diagnostic room.

• Foods that stimulate gas formation in the intestines should be excluded from the child’s diet. This dairy products, carbonated drinks, bananas and grapes, as well as baked goods, bread and legumes, white cabbage.
• You should not give your child anything to eat at least three hours before the examination.
• An hour before the examination, the child should be given water to drink. The bladder should be full. This will help the doctor correctly assess the amount of residual urine and understand the condition of the bladder and ureters. Children aged 1 to 3 years are given 100-150 ml of water or fruit drink, children from 3 to 7 years old are offered a glass (250 ml) of liquid, schoolchildren from 7 to 12 years old - at least 400 ml, teenagers older - 600-800 ml .

An infant under the age of one year does not require any special dietary restrictions. The only requirement is that the child should not be fed at the time of the diagnostic procedure.

It is best to get examined before the next feeding. Before the ultrasound, give your baby about 50 ml of liquid half an hour before the ultrasound, but no one guarantees that he will retain it. If your baby wants to write, he definitely won’t ask your permission to do so at such a young age.

You need to take a clean diaper, second shoes, and your mother’s little “tricks” to distract attention with you to the ultrasound room. If the child is small, this could be a pacifier, a rattle, an object interesting to the child that he has long dreamed of reaching, for example, your glasses. Distracting the baby will allow the doctor to complete the examination in a calm manner.

If your child is at an age where you can explain something to him, be sure to tell him how the procedure goes, emphasizing that it will not hurt at all and will not be scary. The child must be psychologically prepared.

The examination is carried out on a couch in a lying position; only in some cases the doctor may ask the child to sit up if, due to his age, he already knows how to sit. If you suspect kidney prolapse, you are asked to stand up. But during the examination you will have to lie in three positions - on your back, on your stomach and on your side. In such positions for the external sensor used for examination, the doctor will have the most complete overview.

To facilitate the sliding of the sensor and better penetration of ultrasonic waves, a special colorless gel is used, which is odorless and does not cause allergies or local irritation. It is applied to the abdomen, lower back, and sides. The gel does not leave marks on clothing and can be easily wiped off at the end of the study with a disposable dry paper napkin.

The research data is entered into a protocol, which is issued immediately upon completion of the diagnosis.

Norms

Decoding the conclusion is a matter for professionals. Independent conclusions are inappropriate in this case. But if you really want to check the data with existing standards, especially if the doctor was taciturn and did not tell the mother everything he knows, then we present the standards in the table:

Reasons for rejection

An increase in the parenchyma and width of the pelvis is often the first sign of inflammation. It can be caused by salts, metabolic disorders, colds, and viral illnesses. The size of the kidneys, their structure, the condition of the ureters and bladder help to establish the presence of a wide variety of diseases and conditions - glomerulonephritis, pyelonephritis, urolithiasis.

Anomalies in the structure of organs, as well as acquired and congenital tumors and neoplasms, cysts, and impaired urine outflow due to narrowing of certain parts of the kidney and ureter can also be detected. The true causes of the pathology, if any, will help to establish a comprehensive study. The detection of urolithiasis, for example, cannot be considered reliable without confirmation from the laboratory - an increased content of salts (urates, oxalates, etc.) must be detected in the urine.

It should be noted that not all pathologies, especially those early stages, make themselves known by the appearance of characteristic symptoms. Sometimes diseases of the urinary system are discovered completely by accident, when two or three urine tests in a row do not show the best results.

Therefore, you should not refuse an examination if a doctor recommends it. Diseases of the kidneys and bladder respond well to treatment if the problem is detected in time and treatment is started as early as possible. Advanced forms are more difficult to treat.

Many parents note that the data obtained in one clinic may differ significantly from the data obtained in another. Much depends on the qualifications of the doctor, on the permission and quality of the equipment on which the study was carried out. This is why sometimes several different doctors can make completely different diagnoses for the same child.

Many mothers who have the sad experience of numerous studies of kidneys in children urge not to trust tables and standards, not to rely on them, because much in size depends on the child’s height, weight, age and other purely individual developmental characteristics. Ultrasound of the kidneys in adults is more accurate than in children, because the sizes, especially in babies under one year old, are small, the error is quite large. This, according to mothers, quite often becomes the reason for erroneous diagnoses, which are not confirmed over time.

Today, mothers have a wide choice - clinics and doctors for every taste and budget. Reviews from other parents who have encountered problems with underdiagnosis or overdiagnosis during kidney ultrasound will help you find a good specialist. Entire topics on parent forums are devoted to this issue.

To learn how ultrasound is performed on children, see the following video.

Ultrasound should rightfully be awarded the palm among all modern studies. Its important advantage is that it is completely safe for the body. There are also disadvantages - the correctness of the diagnosis seen strongly depends on the qualifications of the ultrasound specialist, as well as on the modernity of the ultrasound machine. But all these things are so clear and obvious, so I mention this only in passing and, therefore, will not expand further on this topic. I want to place the main emphasis on how to properly prepare for an ultrasound, because the reliability of the diagnosis also largely depends on this. Incorrect preparation will be a clear hindrance to the doctor, no matter how super-specialist he is, and no matter what ultra-modern device he uses to carry out diagnostics. And if how to prepare for an ultrasound of the abdominal cavity is more or less clear (show up on an empty stomach and do not consume gas-forming foods the day before), then preparation for an ultrasound of the kidneys and bladder is not entirely clear and understandable.

My daughter is diagnosed chronic pyelonephritis Based on urine tests, the diagnosis was made in the first year of life. Then, an ultrasound scan revealed dilation of the renal pelvis and a deficiency of renal mass. Since then, ultrasound of the kidneys and bladder has steadily entered our lives. We do it once a year on a machine that is considered the best in our city:

Preparation for ultrasound of the kidneys and bladder:

While my daughter was little, there was no talk of any special preparation, they just came for an ultrasound and that’s it. Then they began to do an ultrasound of the kidneys along with the abdominal cavity and, therefore, came in the morning on an empty stomach. But recently, our bladder began to bother us, which was expressed in frequent urination during the day, and it always seemed to my daughter that she had not completely emptied her bladder. And during the next planned ultrasound of the kidneys and bladder, the nephrologist prescribed to look at the bladder before and after urination with determination of residual urine. For ultrasound diagnosis of this problem, it is necessary to come for examination with a full bladder, but no one clearly explained to me how to properly fill the bladder. I thought that the preparation here was similar to the preparation for a gynecological ultrasound, and 2 hours before the ultrasound I forbade my daughter to go to the toilet, and also gave the child 2 glasses of water to drink and then gradually supplemented her with water from a bottle. And it turned out according to the principle - we wanted the best, but it turned out as always. We overdid it. The ultrasound doctor scolded us for such extensive preparation.

And she explained to me how to properly prepare for an ultrasound of the kidneys and bladder. It turns out that water load before an ultrasound of the kidneys is not only NOT necessary, but can also do a disservice - show what is not really there. In particular, when the bladder is full, an expansion of the renal pelvis can be seen on ultrasound. And although this expansion will be temporary, so to speak physiological, the child will eventually be treated for something that in fact is not there at all, and will be further examined in full. Therefore, you need to remember one immutable rule: there is no special need to fill the bladder before an ultrasound of the kidneys. You can drink water, but as usual, do not get drunk under any circumstances, and an hour before the ultrasound, you can drink a small glass of water (about 150 ml) and then stop drinking liquid. In addition, you should not empty your bladder an hour before the examination. The child should only want to go to the toilet a little, and not so much that it is unbearable, and his eyes glaze over his forehead.

Disadvantages of ultrasound of the kidneys and bladder:

1. The information content of ultrasound of the kidneys and bladder is only about 40%. I did not take this figure out of thin air or from the Internet; this figure was voiced to me more than once by a nephrologist, adding that the kidneys, due to some peculiarities, are less visible on ultrasound than other internal organs. And if something is wrong, then additional examinations are necessary to establish a final and correct diagnosis. We are diagnosed by ultrasound with a deficiency of renal mass (the doctor calculates it using a formula where the size of the kidneys depends on the weight of the child)

But the nephrologist reassured us that we need to do other examinations to assess kidney function, which is more indicative, since the size of people’s kidneys may not fall within the normal range, but still function perfectly, and then it will not be a pathology, but individual characteristics body. To assess renal function, we performed dynamic scintigraphy, which, fortunately, did not reveal any serious pathologies. And comparing with the results previous examinations, the nephrologist no longer picks on the renal mass index.

Conclusion: Thus, ultrasound of the kidneys and bladder is an accessible and safe study. And although it does not show 100% of the state of affairs, this method is good because it sees and excludes some serious pathologies, and those minor changes that are often detected by ultrasound can be confirmed or refuted using other examinations. To make a correct diagnosis, it is very important to properly prepare for an ultrasound, eliminating excess water load, since the results of the study may be distorted and, as they say, the whole picture will be blurred. The bladder should fill exclusively in a natural, gradual manner, but an hour before the ultrasound you are allowed to drink a small glass of water.

2 years ago

If a woman begins to complain of discomfort during urination, or has certain problems with this process - delays or frequent urges, feels pain in the lower abdomen, observes blood or mucous clots in the urine, the first and safest examination for internal disorders should be an ultrasound. . This technique allows you to get a quick and high-quality picture if you carry out the right preparation. Ultrasound of the kidneys in women requires knowledge of some nuances, failure to comply with which may distort the result.

This procedure is prescribed not only for obvious symptoms of any diseases of the urinary system. For preventive purposes, ultrasound of the kidneys and bladder in women is done before and during pregnancy, in the presence of a history of chronic kidney disease and even after infectious diseases of the genital organs, long-term acute respiratory viral infections, etc., in order to exclude complications.

Preparation for a kidney ultrasound in women begins a week before the procedure itself, since one of the important points is a temporary adjustment of the diet. For this step to produce results, a couple of days will not be enough.

The diet before such an examination involves the complete exclusion of salty foods to prevent fluid retention, as well as avoidance of alcohol and coffee with high caffeine content. It is advisable to drink weak tea all week and not in large quantities - temporarily leave only clean water and freshly squeezed juices on the menu. Doctors also advise against:

• cabbage of any variety and any type (especially sauerkraut);
• milk and its derivatives (including cheeses);
• potatoes;
• legumes;
• products made from wheat flour;
• confectionery products.

Despite the fact that the examination involves examining exclusively the kidneys and, in rare cases, the bladder, during preparation it is important to take care of cleansing the intestines: if gases accumulate in it, this will complicate the procedure. For this purpose, a woman needs to drink for a week Activated carbon 1-2 tablets daily. This is considered a particularly significant measure with the transrectal method of examination: i.e. through the rectum.

The closer the day of the ultrasound is, the stricter the dietary requirements: in the evening before the procedure and in the morning on “Day X” it is especially important to avoid mistakes. Dinner is served at 18-19 hours, and before going to bed you should do an enema that will remove any leftover food. An alternative is activated carbon tablets (1 piece for each kg of weight). After dinner you can drink water, but even tea is prohibited. On the morning of the kidney ultrasound, it is advisable to have breakfast with something from the list:

• boiled eggs (1 pc.);
• porridge on water;
• chicken breast;
• lean river fish;
• cheese with a minimum percentage of fat content.

If possible, you should stop at only 1 product and try to make a small portion: for meat and fish it is 50-60 g, for cheese - about 50 g, for porridge - 50 g of dry product. Weak green tea is allowed, but it is better to drink water.

On the day of the procedure, about an hour before the procedure, the patient is asked to drink about half a liter of pure water or weak green tea without additives. This is done in order to fill the bladder, remove gases from the intestines, and make the kidneys more visible on the monitor. It is forbidden to defecate until the end of the examination - the doctor will begin the procedure when the patient feels the urge to go to the toilet.

Ultrasound of the kidneys and bladder in women is done in the same way as in men: the patient removes everything from the upper body (excluding underwear), or lifts it up to the chest and lies down on the couch. The doctor moves a special sensor along the lower abdomen, periodically moving to the sides. The duration of the examination is 15-20 minutes, and another 10 minutes. spends on deciphering the results, as well as drawing up a complete summary.

• In rare cases, the kidneys are examined in a patient who is standing rather than lying down - this is necessary to assess their mobility.
• In addition to the classic ultrasound method (externally), there are 3 more options for examination: for women, only 2 – vaginally and rectally. For men, the sensor can also be inserted through the urethra.

What is the norm for kidney ultrasound in women? Experts believe that the thickness should range from 40-50 mm, and the width - 50-60 mm. In this case, the length of the organ does not exceed 120 mm, but should not be less than 100 mm. The tissue itself (parenchyma) in thickness can be 11 mm or even 20 mm, but not go beyond these limits. The main thing is that this indicator is relatively the same over the entire surface area of ​​the organ.

Also, in addition to the numbers, it is important to pay attention to a few more details: the kidney has an ideal shape - an oval, the right one is located slightly lower, and their sizes are approximately equal (an error of 2 mm is allowed). The outer contour has no distortion. If a specialist notices a positive echo response in some formations, this may be a signal of the formation of tumors or stones.

Kidney ultrasound is one of the first diagnostic measures prescribed to determine pathologies of the urinary system.

The reasons for the study are complaints of pain and discomfort in the lumbar girdle, abnormalities in urine tests, problems with urination, swelling and high blood pressure, a history of surgery on the urinary organs, transplantation.

Ultrasound of the kidneys is mandatory for children in the first year of life to determine congenital anomalies of organ structure.

Recently, ultrasound has begun to be included in the standard set of preventive examinations.

The kidneys are rarely examined in isolation from other urinary organs.

For a complete diagnosis, the functioning of the adrenal glands, bladder, blood flow in the renal vessels (Doppler) is additionally assessed; according to indications, an ultrasound of the kidneys is combined with an examination of the organs of the digestive and reproductive systems.

It is generally accepted that there is no special preparation for an ultrasound scan of the kidneys, since the scan is performed from the back and sides, and the contents of the digestive tract cannot distort the results of the study.

In fact, the presence of air in the abdominal cavity is undesirable: gases in the intestines can interfere with the passage of ultrasonic waves and disrupt the information content of the method.

Ultrasound should be excluded from the menu the day before:

• whole milk;
• Rye bread;
• legumes;
• potatoes;
• cabbage;
• raw vegetables;
• fresh fruits, especially apples;
• sweet;
• beer;
• carbonated drinks;
• fatty, fried meat, fish;
• smoked meats;
• rich meat broths;
• other products that cause an individual negative reaction in the patient.

The daily diet should consist mainly of:

• porridge with water (buckwheat, barley, oatmeal);
• boiled lean meat;
• steam cutlets from lean minced meat;
• boiled white fish;
• unsalted, low-fat hard cheese;
• 1 hard-boiled egg per day;
• toasted white bread.

For patients with good digestion, it is enough to follow a gentle diet for 2–3 days.

If you are prone to flatulence, it is advisable to give up gas-forming products for a week and take sorbents.

Preparing for a kidney ultrasound: dos and don’ts

To ensure normal visualization of the kidneys, you need to think about how to prepare for a kidney ultrasound, namely, take care of the cleanliness of the intestines. It should not be full at the time of the procedure.

1. With normal digestion, normal bowel movements in the evening or morning before the ultrasound are sufficient.
2. It is more convenient to prepare for the procedure scheduled for the morning on an empty stomach. The last meal in the evening should be light, 8 – 12 hours before the time of the procedure. This rule is mandatory for patients whose kidney examination is combined with an examination of the abdominal organs.
3. During an ultrasound in the afternoon, you are allowed to have breakfast early in the morning. You can eat a white cracker, a piece of boiled meat, or porridge with water. 1 – 1.5 hours after breakfast, take activated carbon (at the rate of 1 crushed tablet for every 10 kg of body weight) or any other sorbent.
4. Problems with stool must be eliminated. An enema cannot be done immediately before an ultrasound. If there is such a need, cleansing with an enema can be performed 1 to 2 days before the test. It is better to take a mild laxative, put a glycerin suppository or use a microenema (Microlax).
5. You can help digestion by taking enzymes with food (Mezim, Pancreatin, Creon). Food will be better digested, release less gases and be easier to evacuate from the intestines.
6. For flatulence, taking drugs based on simethicone (Espumizan, Simethicone, Simikol, Meteospasmin) is indicated. Excess gases from the intestines are well removed by enterosorbents (activated carbon, Enterosgel, Smecta).

Another condition for a high-quality ultrasound examination is a full bladder.

Diuretics should not be used to prepare a patient for an ultrasound examination..

Immediately before the procedure, 40 - 60 minutes before the appointed time, you need to drink about 500 - 800 ml of clean still water or weak tea without sugar, after which you do not go to the toilet anymore.

Often, if nephropathology is suspected, there is a need to conduct several tests at once. If the patient has been prescribed radiography of the kidneys with the introduction of a contrast agent, after this ultrasound can be performed with a break of 2 to 3 days.

During pregnancy

A pregnant woman's kidneys experience repeated stress.

If expectant mother Late toxicosis develops, the kidneys are among the first to suffer, and based on their condition, early detection of gestosis is carried out.

Often during pregnancy, women develop nephropathy during pregnancy. The only safe method of functional diagnostics during pregnancy is ultrasound.

The use of cleansing enemas, most laxatives, and adsorbents during pregnancy is contraindicated because it can harm the development of the fetus and cause increased uterine tone.

If necessary, to eliminate constipation and flatulence, the doctor will prescribe medications approved for pregnant women. Preparing for a kidney ultrasound during pregnancy involves following a diet that regulates gas formation. When examining the entire abdominal cavity, it is advisable to abstain from eating before the procedure; if you are checking only the kidneys, there is no need to fast. 40-50 minutes before the start, the woman needs to urinate and drink about a liter of liquid.

How to prepare a child

Kidney ultrasound is included in the mandatory screening list for infants aged 1 - 1.5 months.

For other children, ultrasound of the kidneys and bladder is prescribed according to indications.

If an adult child has regular bowel movements and moderate gas formation, it is enough for him to follow general nutritional recommendations before an ultrasound.

Problems with gases are solved with the help of children's medications - Espumisan, Bobotik, Plantex.

Difficulties may be caused by filling the bladder sufficiently for good visualization. Too much urine is just as undesirable as too little urine and can distort the ultrasound signal.

Ultrasound is performed on newborns regardless of whether the bladder is full; the baby must be fed breast milk or mixture 20 minutes before the ultrasound.

An adult child who may no longer urinate for a long time, but who is able to endure the urge when the urge arises, needs to refrain from going to the toilet for 2 to 3 hours to prepare for an ultrasound.

A baby who has poor urinary control should be asked to pee 2.5 - 2 hours before the procedure, then give him a drink at the rate of 5 - 10 ml of liquid per 1 kg of weight.

This could be tea, compote, juice, water - any drink that the child would drink with pleasure, except soda and dairy products.

• 1 – 2 years – 100 ml;
• 3 – 7 years – 200 ml;
• 8 – 11 years – 300 ml;
• over 12 years old – 400 ml.

The entire volume of liquid is drunk immediately, after which you can no longer drink or urinate. It is sometimes difficult to force a child under 2 years old to do this - you can give him a bottle, a sippy cup with a drink for 20 minutes and make him suck at least half a glass of liquid.

Ultrasound is a diagnostic method with proven safety. It is absolutely harmless even for infants and is widely used in women during pregnancy.

The effectiveness of this procedure is quite high, but improper preparation can significantly distort the reliability of the results. To ensure that they are as accurate as possible, patients should not ignore the recommendations for preparing for an ultrasound examination of the kidneys.

The child is scheduled to have an ultrasound of the kidneys soon, they gave a direction, but not a word about preparation. I heard that the child should be given something to drink before the test, but I didn’t know about the effect of gas formation; all the nuances must be taken into account. It’s a pity that such recommendations are not given in clinics or hospitals.

Update: October 2018

Ultrasound examination is one of the most prescribed types of instrumental examination of human organs. This relatively young diagnostic method has a number of significant advantages:

• high information content;
• safety (can be carried out repeatedly);
• no side effects;
• well tolerated by the patient;
• not accompanied by painful discomfort;
• no contrast agent required;
• minimal preparation for the procedure.

Ultrasound occupies a leading position in the diagnosis of kidney diseases. There are 2 types of ultrasound diagnostics of the kidneys:

Ultrasound echography is based on the reflection of sound waves from the boundaries of tissues with different densities, and allows you to examine the renal parenchyma, detect conglomerates and neoplasms, as well as topographical disorders.
Doppler ultrasound based on the Doppler effect. Using the method, you can assess the state of blood circulation (changes in the direction of blood flow) in the vessels of the kidneys.

About the safety of ultrasound: back in 1979, the American Institute of Ultrasound (Bioeffects Committee) made a statement about the absence of adverse biological effects when performing ultrasound . And over the past quarter century, no reports of negative consequences of this procedure have been recorded.

This procedure does not use radiation, there are no negative effects at the site of contact of the skin with the sensor, there may be risks that depend on the individual health status of the patient, which should be discussed before the procedure with the attending physician. There are conditions that can make kidney testing difficult:

• significant obesity
• presence of gases in the intestines
• presence of barium in the intestines after a recent barium study

Preparing the patient for a kidney ultrasound

Preparing for an ultrasound of the kidneys is not difficult, but it plays a role important role in the effectiveness of the research. The fact is that ultrasound does not pass through the air and gases that are present in the intestines. So, how to prepare for an ultrasound of the kidneys and adrenal glands?

3 days before the ultrasound you should:

• Eliminate from your daily diet foods that increase or provoke gas formation: brown bread, potatoes, fresh milk, cabbage and other raw vegetables and fruits, as well as sweets.
• Take enterosorbents for 3 days: white or black coal, espumisan, fennel. This will reduce gas formation.
• The evening before the test, you can have dinner with easily digestible food no later than 19:00.
• If only a kidney ultrasound is planned on the day of the study, there are no restrictions on food intake. If the entire abdominal cavity is examined, then you should not eat anything before the examination.
• If the bladder is also examined, it should not be emptied before the ultrasound. 1 hour before the procedure, drink 1.5-2 glasses of water, but if the bladder is too full by the time of the examination, you need to empty it slightly.
• Not all medical institutions provide disposable wipes for removing gel, so it is better to take a towel with you.

The special gel used during the procedure does not stain clothes, but it cannot be completely removed after an ultrasound, and it does not wash well, so it is better to wear not particularly smart clothes for the examination.

Indications for kidney ultrasound

What is a kidney ultrasound procedure?

• An ultrasound uses a device (transducer) that sends out high-frequency ultrasound waves so they cannot be heard. These waves, with a certain location of the transducer on the body, pass through the skin to the organs needed for examination. Supersonic waves are reflected from the organs like an echo and return to the transducer, which displays them in an electronic picture.
• The applied gel ensures more efficient movement of the transducer and eliminates the presence of air between the skin and the device, since the speed of ultrasound propagation is the slowest through air (the fastest through bone tissue).
• During a Doppler ultrasound of the kidneys, blood flow in these organs can be examined and assessed using special supersonic waves. Weak signals or their absence indicates the presence of obstructions to blood flow within the blood vessel.
• Kidney ultrasound is successfully used during pregnancy or if the patient is allergic to contrast agents that are used during other studies.

In addition to ultrasound, the patient may be shown other studies: CT, renal angiography, renal radiography, antegrade pyelography.

Immediately before an ultrasound examination of the kidneys you should:

• Remove all jewelry, all clothing, and other objects that interfere with the study.
• The doctor may suggest wearing a special gown
• During the examination, you will need to lie motionless on your stomach, on your back and turn on your right and left sides.
• The doctor may ask you to hold your breath, inflate your stomach, and take a deep breath.
• A special gel is applied to the area to be examined, then using the ultrasound machine’s sensor, the doctor begins to examine the organs.
• The examination begins with the bladder and ureters, then the condition of the kidneys is assessed.
• If you need to evaluate blood flow, a whistle and noise will appear - this is how an ultrasound with Doppler is performed.
• The patient does not experience any discomfort during the ultrasound examination, except for the sensation of a cool and moist gel.
• The duration of the procedure is 10-15 minutes.
• When examining a urinary tract, it is first examined in a full state, then an additional examination is carried out in an empty state.
• The gel is removed with a napkin immediately after the procedure.

The result of the kidney ultrasound is attached in the form of a black and white photo to the written report. If a pathology is detected (stones, cyst, tumor), it will be shown in the photo so that the attending physician can better understand the picture of the disease. If necessary, a video recording of the study can be attached to the conclusion.

What does a doctor determine when performing an ultrasound diagnosis of the kidneys?

During the examination, the doctor determines:

• location of the kidneys;
• shape and contours of the kidneys;
• kidney size;
• parenchyma structure;
• kidney blood flow;
• pathological formations such as stones, tumors, cysts, sand.

Ultrasound results - main indicators

Dimensions and topography

Normally, each kidney in an adult has the following parameters:

• length 10-12 cm
• width 5-6 cm
• thickness 4-5 cm
• parenchyma thickness ranges from 15-25 mm

The right and left kidneys may differ in size, but no more than 2 cm in any of the indicators. The shape of the bud is bean-shaped. Topographically, the kidneys are located retroperitoneally, on both sides of the spine at the level of the 12th thoracic, 1st and 2nd lumbar vertebrae, with the right kidney located slightly lower than the left. When breathing, the kidneys can move by 2-3 cm. The kidneys are enveloped in fatty tissue on all sides.

• A decrease in kidney size can be observed in chronic pathologies that occur with the destruction of renal tissue, as well as in other degenerative processes.
• An upward change in kidney size occurs in the presence of neoplasms, congestive processes and various inflammatory pathologies.
• A decrease in the size of parenchyma (kidney tissue) occurs with age, especially noticeably after 60 years.

Fabric structure

The structure of the kidney tissue is uniform or homogeneous, without inclusions. Cortico-medullary differentiation (visibility of the renal pyramids) should be clearly expressed. The renal pelvis - the cavity inside the kidney - should not contain any inclusions.

Changes in the structure of the kidneys occur in various diseases. The presence of formations inside the renal pelvis (sand, stones) indicates urolithiasis.

Let us separately dwell on the results of ultrasound of the adrenal glands - small but very important organs of the endocrine system. The adrenal glands may not be visualized in people with increased body weight. The right adrenal gland has a triangular shape, the left one has a semilunar shape, the echostructure of the organs is homogeneous.

Explanation of medical terms and concepts during ultrasound of the kidneys

It is difficult for ordinary people who do not have medical knowledge to understand the intricacies of medical terminology. Here is a breakdown of the main terms that may appear in the conclusion of an ultrasound specialist. But you should not engage in self-diagnosis; this is solely the prerogative of the doctor.

Increased pneumatosis intestinalis

This term implies a pathological accumulation of gases in the intestinal cavity and indicates that the conditions for ultrasound diagnostics were unsatisfactory (poor preparation of the patient for the study). As a rule, this phrase is placed at the beginning of the conclusion. Most likely, the ultrasound will have to be done again.

Basic concepts (structural)

• Fibrous capsule- this is the outer membrane of the kidneys, which normally should be smooth, up to 1.5 mm wide and clearly visible.
• Parenchyma is the tissue of the kidneys.
• Pelvis- the cavity inside the kidneys in which urine coming from the kidney calyces is collected.

Terms characterizing kidney pathology

• Nephroptosis – prolapse of the kidney.
• Echopositive or mass formation. This term describes a tumor in the kidney.

If we are talking about a malignant formation, then the structure of the tumor is heterogeneous, has areas of reduced or increased echo density, echo-negative zones, and also an uneven contour. A benign tumor is described as a hyperechoic or homogeneous mass. When any neoplasm is detected, its location, shape, size, as well as the echogenicity and echostructure of the tumor tissue must be indicated. For kidney tumors, the diagnostic accuracy of ultrasound is 97.3%.

• Anechoic, space-occupying formation- cyst in the kidney. The location of the cyst, its shape, size and contents must be indicated.
• Microcalculosis, microliths- small stones or sand in the kidneys (up to 2-3 mm).
• Echoten, echogenic formation, conglomerate, hyperechoic inclusion - kidney stones. Their location, quantity, on which side they were detected, diameter and size, presence or absence of an acoustic shadow must be indicated.
• Increased or decreased echogenicity of renal tissue– change in tissue density due to disease or infection.
• Hypoechoic areas in renal tissue- tissue swelling (often observed with pyelonephritis).
• Hyperechoic areas in renal tissue- hemorrhages into the kidney tissue.
• Spongy kidney is a congenital cystic change in various structures of the kidney, giving it a spongy appearance.
• Enlarged renal pelvis– pathological condition, because Normally, the pelvis is not visualized. Occurs with obstruction of the urinary tract of various origins.
• Consolidation of the mucous membrane of the renal pelvis– pathological swelling of tissue of an inflammatory nature, often observed with pyelonephritis.

Of all echo-positive (solid) kidney tumors, renal cell carcinoma is considered the most common (85-96%). Benign tumors - adenoma, oncocytoma, leiomyoma, angiomyolipoma, etc. account for 5-9%.

Kidney ultrasound is a simple test that anyone can undergo as prescribed by a doctor or at their own request. It is carried out both on a budgetary basis and for a fee, in public and commercial medical institutions that have ultrasound equipment. The price of an ultrasound examination of the kidneys varies depending on the region, from 400 to 1200 rubles.