The size of the kidney is normal, structure and function. Ultrasound of the kidneys: the norm for children and adults and decoding The norm for the size of the kidneys of women ultrasound

In modern medicine, ultrasound diagnosis of the kidneys is of particular importance. It is a minimally invasive procedure that allows you to accurately determine all the indicators of interest. These include the size, shape, even the location of the organ. In addition, considerable attention is paid to the study of the ureter and bladder.

Thanks to such diagnostics, it is possible to accurately, quickly and effectively study almost all diseases of the urinary tract. The method allows you to evaluate the blood flow, as well as to evaluate its structure and structure.

An ultrasound is necessary if:

• An ultrasound of the kidneys is prescribed by a doctor in case of revealing some dangerous symptoms. They may appear as a consequence.
• Improper functioning of the endocrine system. Various inflammatory processes that have a chronic or acute form; pain in the lumbar region.
• Urinary incontinence, characteristic pathological formations.
• Damage during trauma: genital organs with congenital pathology. It is observed equally in both men and women.
• Suspicions of the presence of a number of inflammations, which are the result of diseases.
• Ultrasound diagnostics can be recommended for patients who suffer from high blood pressure. Often it cannot be reduced, even using the therapy prescribed by the doctor.
• The doctor may recommend that the expectant mother undergo an ultrasound examination during the period of gestation. Such a recommendation may be the result of a number of complaints of progressive pain in the renal region.

Pregnancy is a factor provoking the progression of existing ailments.

• Often, before getting a job or in the process of medical examination, doctors may recommend that patients undergo an ultrasound examination of the kidneys for preventive purposes.

Regarding contraindications, they do not exist, but, despite this, some doctors prohibit ultrasound examination of the kidneys and bladder for those patients who have an inflammatory reaction and skin dermatitis. It often manifests itself in the lumbar region.

Before the procedure, a special gel is applied to the area under study. In some people, it is he who causes an allergy or inflammatory reaction, so such a reaction is considered a contraindication for ultrasound.

Kinds

Ultrasound is divided into two types:

1. Ultrasound echography. This view is based on the ultrasonic wave method and its ability to show the contours of tissues of various densities. The study is used to diagnose deformities of the renal tissues, with an incorrect topographic location of the organ.
2. Doppler ultrasound, it is also called the study of renal vessels. This method is based on changing the frequency and, accordingly, the wavelength of the radiation. It consists of differences in reflected frequencies and shaped blood elements. Also, the study takes into account the frequency of ultrasonic waves and the frequency of the waves that are emitted by the device. The doctor conducts a visual analysis of the test results, thanks to which you can see the direction of blood flow.

What does ultrasound show

Thanks to ultrasound, you can immediately detect:

• Deformations and changes that relate to the urinary system.
• inflammatory processes.
• Various injuries.
• Anomalies as a result of abnormal intrauterine development.
• Diseases in the vascular system.

Norm for adults and children

It is difficult to determine normal indicators, because this term should be based on at least the age and gender of a person. Relatively normal are considered indicators that are equal to such numbers: 40 - 50 x 50 - 60 x 100 - 120. The thickness, width and length of the organ are taken into account here.

The thickness of the parenchyma is a relative concept that changes with age.

Indicators are considered the norm, based on which the doctor excludes or confirms whether there is a structural pathology.

The following entries are also considered normal:

• The organ resembles a leguminous plant in external characteristics. The contour outside is highlighted with straight lines.
• The kidney located on the left is several centimeters higher than the right one, the echo density of the renal pyramid is below the parenchyma.
• Hyperechoic capsule up to 0.15 cm thick
• The sinus of the kidney is equal in echo density to the tissue near the kidneys.
• echogenicity. In the kidneys with the organ that produces bile, they are the same or the indicators can be significantly reduced.
• Often the phrase "Bertin's columns" or "partial increase in tissue" of the renal cortex is used. These indicators should not disturb the patient.
• The doctor should not visualize the pelvicalyceal system.
• Normal are the anterior and posterior dimensions up to 0.15 cm.
• The mobility of the organ during breathing is from twenty millimeters.
• The kidneys must be the same size, or one may be larger than the other by a maximum of 2 cm.
• In dense people, the kidney may not be fully visualized.
• The shape of the right adrenal gland resembles a triangular, the left - the moon.
• Clarity in capsules is not traced.
• Even if the patient has tumors, they may not be visualized.

Also, the protocol for ultrasound of the kidneys has the following points:

• Structural anomaly. Here the doctor must emphasize whether there is a malignant formation, developmental anomalies, which consist in tissue underdevelopment, cysts, spongy structure of the kidney.
• Whether or not massive formations exist, their location is also displayed, echogenicity and echostructure are taken into account.
• Diameter and presence of stones. Their location, the presence of an acoustic shadow are also indicated.

The norm in children

If we talk about ultrasound of the kidneys in children, then the age of the child himself will be the basis of the indicators.

The norm for the size of the kidneys in cm for children:

Norm for pregnant women

Defined by the following parameters:

1. Where is located. The location of the kidneys on two sides of the spine is considered the norm. It is important that the level is taken into account: 12 thoracic and 1-2 lumbar vertebrae. The right kidney is often visualized slightly lower than the left;
2. motor features. The organ can move, only these movements will be limited and only they are possible vertically. Increased mobility is considered a pathology;
3. Dimensions. This parameter is extremely important, because it is based on changes that may indicate some diseases. Most often they relate to the urinary system. So, if the organ is significantly enlarged in size, this may indicate inflammatory processes, neoplasms can develop in the kidneys. On the contrary, if the organ decreases, this symbolizes severe chronic ailments, the kidney tissue is broken or dystrophic processes develop;
4. The renal pelvis should be free, sand or stones should not be traced in it, all this symbolizes urolithiasis;
5. The fibrous capsule should normally be flat.

What diseases are detected by ultrasound of the kidneys

The main diseases that are detected by ultrasound:

1. Kidney ailments.
2. Chronic and acute form of inflammatory kidney disease of bacterial etiology.
3. Vessels of the kidneys with obvious defects, which leads to improper outflow of urine and blood supply to organs.
4. The cyst has a rounded shape, there is fluid inside.
5. Formations of malignant and benign type.

Deciphering the ultrasound of the kidneys

To decipher the results of the ultrasound, here is a list of items that are considered during the examination:

• Parenchyma thickness

The concept under consideration is the renal tissue, which consists of microscopic formations, nephrons, which are a filter element. The parenchyma is located on the surface of the organ, and inside you can find a cavity - a cup that goes into the pelvis. The latter then becomes several times smaller and finds its continuation in the ureter. The thickness of the kidney tissue of a person who does not complain about his health. equal to 15 to 25 mm. With its increase, this symbolizes inflammatory edema, with its decrease, it symbolizes processes of a dystrophic type. Actually, the parenchyma often becomes thinner over the years. After 60 years, indicators can decrease by a centimeter per year, this is often considered the norm.

• Changes in the parenchyma

In the description of studies, such a concept as “increase in echogenicity” or “decrease in echogenicity” can be written. This symbolizes the defeat of the organ by some kind of ailment, which negatively deformed the dense tissue. Only a doctor should diagnose what exactly affected such changes, because ultrasound will not indicate how much the echogenicity has changed. Often, the parenchyma is affected by cysts - malignant formations that are filled with fluid inside; if they are small in size, do not develop further and do not harm the body and organ, there is no need to treat them. But when they actively develop, cause the manifestation of certain symptoms, or are characterized by uncharacteristic external deformations, there is a possibility that this is not a cyst for a long time, but a tumor. Such a word as “tumor” is rarely found in documents.

• Changes in the pelvis

They are represented by seals of the mucous membrane (symbolizes the inflammatory process). Also, their deformations symbolize the presence of stones or sand. Normally, the tissue of the organ under study should be homogeneous, and there should be no sand or stones in the pelvis. Otherwise, it symbolizes urolithiasis. The chief physician should pay attention to the size of the stones (if any). It directly depends on whether they can leave the body on their own or for this it is necessary to perform certain procedures.

Cost of the procedure

The cost of the procedure is based on the prestige of the clinic, the professionalism and diploma of specialists, the quality of the equipment and its novelty. Below are the average prices, they can be significantly lower or higher:

• Moscow - from 1.5 thousand rubles.
• St. Petersburg - from 800 rubles.
• Yekaterinburg - from 500 rubles.
• Novosibirsk - from 1000 rubles.

Preparing for an ultrasound

The stage has special requirements. The main thing is to fill the bladder before conducting examinations, so the patient should drink plenty of fluids an hour before going to the doctor.

An ultrasound of the kidneys allows you to accurately determine the presence or absence of a particular disease, which can adversely affect the general condition of a person.

You can also learn about ultrasound of the kidneys from this video.

The human kidney is a paired organ that constantly cleanses the blood of foreign substances that can harm the human body. Therefore, it is highly desirable to control the state of this body.

In particular, one of the most important diagnostic parameters is the size of the kidney, which depends on gender, age, body mass index.

What determines the size of the kidney?

It is known that the size of the kidney in men is noticeably larger than in women, which is due to the fact that the size of the body in men themselves exceeds the size of the female body.

In addition, it was found that the difference between the length indicators of the right and left kidneys is insignificant, but it exists, and consists in the fact that, on average, the left kidney is 5% more than the right one. Perhaps this is due to the fact that the vertical liver prevents the growth of the right kidney.

It is also known about the influence of age on the size of the kidney of an adult. The growth of the kidneys occurs up to twenty-twenty-five years, then they remain in a relatively stable state, and after fifty they begin to decrease.

The size of the kidney is also closely related to the body mass index, with an increase in which not only the size increases, but also the height, volume and growth of the kidneys.

Kidney hypertrophy is also observed with the development of diabetes mellitus or hypertension.

Normal kidney size in adults

• Normally, an adult, on average, lies in the range from 80 to 130 millimeters (more precisely, 100 - 120).
• Usually the length of the kidney should be equal to the height of three lumbar vertebrae.
• The width of the kidney lies in the range of 45 - 70, and the thickness - 40 - 50 millimeters.

Regardless of the size of the kidney, the ratio of length to width is 2:1.

In young people, the normal parenchyma (thickness) of the kidney is in the range of 15 - 25 millimeters. Over the years, inflammation or atherosclerotic processes thin it, and at the age of over sixty, the thickness of the parenchyma often does not exceed 11 millimeters. To numerically evaluate the structure of the kidney in medicine, the parenchymal-pyelic index is used.

For ease of perception, we note that in a healthy person, the size of the kidney does not exceed the size of a fist.

Kidney size in children

In childhood, it is somewhat more difficult, since all children develop in different ways. With reference to age, the average length of the kidneys is: from birth to two months 49 millimeters, then up to a year - 62, and from a year to five already 73 millimeters.

• from 5 to 10 years, the size is 85 millimeters,
• up to 15 years - 98,
• and up to 19 years - 106.

That is, in infants, the mass of the kidney in relation to body weight is three times more than in adults.

However, one should not carefully read the results of, for example, an ultrasound examination, since the decoding of ultrasound of the kidneys should be carried out only by a doctor. It not only focuses on the compliance with the norm of human kidney parameters, but also takes into account the specific clinical picture and history.

Ultrasound diagnostics of the pathology of the urinary system received positive feedback from both medical workers and patients. Of particular importance is the ultrasound diagnosis of nephropathology in women during pregnancy. It has won a worthy place among diagnostic procedures due to its safety, simplicity and effectiveness. For example, ultrasound is the main method for diagnosing hydronephrosis. Quite often prescribed together with ultrasound of the bladder and its ducts.

Indications for ultrasound of the urinary system

Any study, even as safe and non-traumatic as ultrasound, must be carried out according to indications. For an ultrasound examination, the reasons for diagnosing are:

• observation in chronic diseases of the urinary system (pyelonephritis, glamerulonephritis, cysts, etc.);
• preventive examination;
• regular migraine headaches, as well as on the background of hypertension;
• swelling of the lower extremities, face;
• endocrine diseases;
• congenital pathologies of the genital organs;
• injuries and pain in the lumbar region;
• violation of urination (increased frequency, incontinence, pain in the process), suspicion of hydronephrosis;
• renal colic;
• changes in OAM data (protein, blood, mucus in the urine).

Ultrasound is also prescribed in the case when the patient experiences the first symptoms of the appearance of foreign bodies in the kidneys to identify their parameters and structure. The examination is carried out in violation of the outflow of urine to detect inflammation and determine the size of the renal pelvis, if the development of malignant neoplasms is suspected, with severe edema in pregnant women, as well as to determine the location of the kidneys and their size during a physical examination.

Pathologies detected by ultrasound diagnostics

What does a kidney ultrasound show? The ultrasound diagnostic procedure can reveal a number of changes in the urinary system from simple to very serious:

• inflammatory diseases of the urinary system (for example, prielonephritis);
• traumatic diseases;
• congenital anomalies;
• neoplasms;
• diseases of the vascular system of the kidneys (ultrasound of the vessels of the kidneys is possible);
• lesions of parenchymal tissues;
• trauma;
• hydronephrosis.

Parameters evaluated during ultrasound examination

In ultrasound diagnostics, the number of organs (one, two, the presence of an additional organ), mobility, location and shape, parameters and structure are evaluated, the renal pelvis and ureters are studied. In the normal state of the body, the mobility of the organs is not great and amounts to one and a half centimeters. In the case of omission or with the so-called "wandering" kidney, mobility increases.

Normal position of the kidneys- on both sides of the spinal column (left above right). However, they can change their location and be on one side (one under the other), in the pelvic area (such a prolapse of the kidneys is called nephroptosis).

normal form for this organ - a bean grain. In the case of developmental anomalies, organs can take the form of a horseshoe, the English letters “S” and “L”, sometimes their fusion is observed.

One of the most important diagnostic indicators is the size of the kidneys. These parameters are different for children and adults. For children, there is a separate table with the norms of indicators and their interpretation. But no matter what the features of deciphering the results of ultrasound of the kidneys in children or pregnant women are, most diseases of the urinary system are accompanied by changes in the size of the kidneys (for example, hydronephrosis leads to an increase in this organ).

Normal sizes kidneys in an adult are as follows:

• the thickness of the renal parenchyma is about 23 mm;
• length is 100-120 mm;
• the organ has a width of 40-50 mm;
• the thickness of the organ is about 45-55 mm, the renal capsule is about 1.5 cm;
• one organ weighs 120-200 gr.

An increase in these parameters indicates inflammatory processes: we can talk about pyelonephritis, hydronephrosis. A decrease occurs in hypoplasia and some other diseases and developmental anomalies.

There is also a decrease in the parenchyma of the kidney with age, after surgical interventions associated with the removal of the kidney. The remaining organ, taking over the functions of a distant colleague, may undergo changes in the direction of increase.

Structure healthy kidney is not homogeneous, the contours are visualized as smooth and clear. The development of any disease affects this structure. Seals of some structures indicate inflammation, the presence of foreign formations (conglomerates, calculi) indicates the accumulation of sand and stones or the development of a tumor. Echo signs of hydronephrosis are: an increase in the affected organ and the accumulation of fluid in its cavities.

Calyces and renal pelvis normally should not be visualized. They are anechoic in nature and are determined by ultrasound diagnostics only with the development of the pathological process. For example, the expansion of the pelvis indicates the development of pyelonephritis, hydronephrosis and calculosis.

Ureters have a normal length of 25-30 cm, normally have light walls on ultrasound, with a dark cavity. In the case of pathological bends, shortening / lengthening of the ureters, the outflow of urine is disturbed and infectious processes develop. Ureter duplication may also occur, and the place where the ureter opens into the kidney may be blocked by a valve. In addition, there may be a stone in the ureter. All these changes will reveal ultrasound.

Deciphering the ultrasound data and the doctor's conclusion

Deciphering the ultrasound of the kidneys is the business of a qualified specialist. However, anyone can get acquainted with the basic concepts that may appear in the conclusion of an ultrasound diagnostics doctor. Often there are results of the following nature:

• Volumetric echo-positive formations - neoplasms. In the case of homogeneity, we are talking about a benign education. In the case of heterogeneity and an uneven contour of the formation, we are talking about a malignant tumor.
• Cysts are located as non-echoic (anechoic) space-occupying formations. Their parameters and content are indicated in the conclusion.
• Microlites are sand or small stones up to 3mm.
• Conglomerate (echoten, hyperechoic formation) - stones.
• The presence of hypoechoic zones in the renal parenchyma indicates edema (a common sign of pyelonephritis).
• The presence of hyperechoic zones in the renal parenchyma is evidence of hemorrhage.
• A spongy structure may indicate a congenital cyst.
• Enlargement of the pelvis indicates hydronephrosis and obstruction of the ureters.
• Thickening of the mucous membrane of the renal pelvis indicates swelling of the tissue, this is another evidence of pyelonephritis.

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 pain discomfort;
• does not require the introduction of a contrast agent;
• minimal preparation for the procedure.

In the diagnosis of kidney diseases, ultrasound occupies a leading position. 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 explore the kidney parenchyma, detect conglomerates and neoplasms, as well as topography disorders.
Doppler ultrasound based on the Doppler effect. Using the method, it is possible to 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 during ultrasound. . And over the past quarter century, no reports of the negative consequences of this procedure have been registered.

This procedure does not use radiation, there is no negative impact at the point of skin contact with the sensor, and there may be risks that depend on the individual health of the patient, which should be discussed with the attending physician before the procedure. There are conditions that can create difficulties in examining the kidneys:

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

Preparing the patient for an ultrasound of the kidneys

Preparation for ultrasound of the kidneys is simple, but plays an important role in the effectiveness of the study. 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 should:

• Exclude from the daily diet foods that increase or provoke gas formation: black bread, potatoes, fresh milk, cabbage and other raw vegetables and fruits, as well as sweets.
• Take enterosorbents for 3 days: white or black coal, espumizan, fennel. This will reduce gas production.
• On the evening before the study, you can dine with easily digestible food no later than 19 hours.
• If only ultrasound of the kidneys is scheduled on the day of the study, there are no restrictions on food intake. If the entire abdominal cavity is examined, then nothing should be eaten before the examination.
• If the bladder is also examined, then it should not be emptied before the ultrasound. 1 hour before the procedure, drink 1.5-2 glasses of water, but if the urinary bladder is too full by the time of the examination, it is necessary to empty it slightly.
• Not all medical institutions provide disposable wipes for removing the gel, so it is better to bring a towel with you.

The special gel used during the procedure does not stain clothes, however, it will not be possible to completely remove it after an ultrasound scan, and it does not wash well, so it is better to wear not particularly elegant clothes for the study.

Indications for the appointment of ultrasound of the kidneys

What is a Renal Ultrasound Procedure?

• Ultrasound uses a device (transducer) that sends out high-frequency ultrasound waves so that they cannot be heard. These waves, at a certain location of the transducer on the body, pass through the skin to the organs necessary for examination. Supersonic waves are reflected from the organs in the form of an echo and returned to the transducer, which displays them in an electronic picture.
• The applied gel provides a more efficient movement of the transducer and eliminates the presence of air between the skin and the device, since the speed of ultrasound propagation through the air medium is the slowest (through the bone tissue is the fastest).
• With a Doppler study during an ultrasound of the kidneys, it is possible to examine and evaluate the blood flow in these organs using special supersonic waves. Weak signals or their absence indicates the presence of obstructions to blood flow within the blood vessel.
• Ultrasound of the kidneys 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, other items that interfere with the study.
• The doctor may suggest wearing a special gown
• During the study, 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, take a deep breath.
• A special gel is applied to the area of ​​study, then, using the sensor of the ultrasound machine, 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 the blood flow, then whistling and noise will appear - this is how Doppler ultrasound is performed.
• The patient does not experience any discomfort during the ultrasound examination, except for the feeling of a cool and wet gel.
• The duration of the procedure is 10-15 minutes.
• When examining the urinary tract, it is first examined in a filled state, then an additional examination in an empty state.
• The gel is removed with a tissue immediately after the procedure.

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

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

During the study, the doctor determines:

• the location of the kidneys;
• the shape and contours of the kidneys;
• kidney size;
• the structure of the parenchyma;
• 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 kidney may differ in size, but not more than 2 cm in any of the indicators. The shape of the kidney 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, while the right kidney is slightly lower than the left. When breathing, the kidneys can move by 2-3 cm. From all sides, the kidneys are shrouded in fatty tissue.

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

fabric structure

The structure of the renal tissue is homogeneous or homogeneous, without inclusions. Cortico-medullary differentiation (visibility of 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.

Separately, we 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 overweight people. The right adrenal gland has a triangular shape, the left one is lunar, the echostructure of the organs is homogeneous.

Deciphering medical terms and concepts for 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 decoding of the main terms that may be found in the conclusion of an ultrasound doctor. But you should not engage in self-diagnosis, this is exclusively the prerogative of the doctor.

Increased intestinal pneumatosis

This term implies a pathological accumulation of gases in the intestinal cavity and indicates that the conditions for conducting 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 shell of the kidneys, which should normally be even, up to 1.5 mm in width and clearly visualized.
• Parenchyma is the tissue of the kidneys.
• Pelvis- a cavity inside the kidneys, in which the urine coming from the renal calyces is collected.

Terms characterizing the pathology of the kidneys

• Nephroptosis is a prolapse of the kidney.
• Echopositive or space-occupying 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, as well as an uneven contour. A benign tumor is described as a hyperechoic or homogeneous mass. If any neoplasm is detected, its location, shape, size, as well as echogenicity and echostructure of the tumor tissue must be indicated. With kidney neoplasms, the diagnostic reliability of ultrasound is 97.3%.

• Anechoic, volumetric education- a cyst in the kidney. Be sure to indicate the localization of the cyst, its shape, size and contents.
• microcalculosis, microliths- small stones or sand in the kidneys (up to 2-3 mm).
• Echoten, echogenic formation, conglomerate, hyperechoic inclusion - kidney stones. Be sure to indicate their localization, the number, from which side they were detected, the diameter and size, the presence or absence of an acoustic shadow.
• Increased or decreased echogenicity of the renal tissue- a change in tissue density due to disease or infection.
• Hypoechoic areas in the kidney tissue- swelling of the tissue (often observed in pyelonephritis).
• Hyperechoic areas in the kidney tissue- hemorrhages in the tissue of the kidneys.
• Spongy kidney - a congenital cystic change in various structures of the kidney, giving it a spongy appearance.
• Enlargement of the renal pelvis- a pathological condition, because Normally, the pelvis is not visualized. Occurs with obstruction of the urinary tract of various origins,.
• Thickening of the mucous membrane of the renal pelvis- pathological tissue edema of an inflammatory nature, often observed in pyelonephritis.

Of all the echopositive (dense) neoplasms of the kidneys, the most common (85-96%) is renal cell carcinoma. Benign tumors - adenoma, oncocytoma, leiomyoma, angiomyolipoma, etc. make up 5-9%.

Ultrasound of the kidneys is a simple study 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 state 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.

Conducting an ultrasound examination of people is the most accessible, informative and painless diagnostic method. Ultrasound is often used to diagnose pathologies of the urinary system. On ultrasound, the size of the kidney, its location, the structure of the renal tissue (parenchyma) and the functionality of both organs are determined. Any pathology is visible on an ultrasound examination in the form of increased or reduced echogenicity (intensity of the shade of organ tissues). It is by the strength of the reflection of ultrasound and by the change in the intensity of the darkening that the specialist issues a conclusion.

Important: deciphering the ultrasound of the kidneys is not yet an accurate diagnosis. To put it, the attending physician is obliged to compare all the data obtained in the form of an ultrasound protocol, laboratory blood and urine tests, and, if necessary, additional results of hardware diagnostics (CT, MRI, radiography, etc.).

Anatomy of the human kidney structure

It should be understood that, like all internal organs, the kidneys are supported by a musculoskeletal structure (CMS). That is why it is so important to have a well-developed and trained body, which will become a protective barrier for vital systems.

It should be understood that the size of the kidney of an adult and a child, as well as its structure, have a certain norm, and any deviations from it are considered a pathology. The kidneys normally have the following structure:

• View of the bean elongated along the form.
• From above, the organ is covered with connective tissue (fibrous capsule) and supported by a fatty capsule.
• Under the fibrous capsule is the parenchyma of the organ (its main tissue), which consists of the medulla and cortex. It is in the parenchyma that various formations in the form of cysts, abscesses, etc. are most often localized.
• One of the structural units of the kidney is the nephron, which is responsible for filtering the blood and processing waste materials into the primary urine.
• The renal pelvis is located inside the parenchyma and is designed to collect primary urine.
• The ureter is one of the parts of the organ that receives primary urine for its further transportation through the urinary tract.
• The renal artery is a vessel through which blood contaminated with decay products enters the kidneys.
• The renal vein is the vessel through which purified blood flows back into the vena cava.

The size of the kidneys is normal

It is worth knowing that the normal sizes of the kidneys in women and men, in an adult and a child are somewhat different and look something like this:

• The adult kidney has a length of 10-12 cm;
• Width - up to 6 cm;
• Thickness - 4-5 cm;
• The thickness of the parenchyma (kidney tissue) is 1.5-2.5 cm.

Children's kidney has sizes depending on age:

• Infant from birth to 2 months - 49 mm;
• Baby from 3 to 12 months - 63 mm;
• Child 1-5 years old - 72 mm;
• Child 5-10 years old - 85 mm;
• Teenager 10-15 years old - 98 mm;
• Young man 15-19 years old - 106 mm.

At the same time, to determine the exact size of the organ, the height and weight of the child is always taken into account. It is worth knowing that in newborns, the ratio of kidney size to body weight is three times greater than in an adult.

Factors affecting the change in the size of the kidneys

The size of the kidneys on ultrasound may differ slightly from the norm. Moreover, if these are deviations in one or all parameters at once within 1 cm, then there is no reason for concern. If the organ is enlarged by several centimeters in one or more parameters, then you need to look for a pathology. However, there are also permissible deviations in the greatness of the organs. Thus, the following has been proven:

• With ultrasound of the kidneys, the norm may be a unilateral increase in the urinary organ. That is, one kidney will be larger than the other. As a rule, this applies to the left. The right, in most cases, is 5% less than the left due to the effect of the liver on it. That is, the liver simply interferes with the normal growth of the kidney.
• It is also worth understanding that the normal size of the kidneys in men is somewhat different from the female urinary organs. That is, the kidneys of an adult male are larger. This is due to physiology - the male body is wider and larger than the female.
• Age also affects the size of the kidneys. So, human kidneys grow up to 20-25 years. After that, the paired organ remains in a stable size up to 50 years. And already with the age of 50+, the kidneys begin to decrease in size, but at the same time they do not lose their function.

Important: the thickness of the kidney parenchyma also depends on age. So, up to 50 years it is 1.5-2.5 cm, and later it decreases and by the age of 60 it is 1.1 cm.

Pathological changes in kidney parameters

In turn, a pathological change in the size of the urinary organs (increase or decrease due to illness) occurs for the following reasons:

• Nephrites in an acute form. Nephrites are called inflammatory processes that began as a secondary pathology after an infectious disease or developed primarily after an infection entered the urinary system through the urethra.
• Hydronephrosis. Or in a simple way, the overflow of the bowl / pelvis of the organ with urine. Such a pathology occurs if a patient has microcalculosis (the presence of kidney stones). When moving, the stone can block the ureter and then the outflow of urine will be difficult. Such a pathology requires urgent surgical intervention, otherwise the patient is threatened with rupture of the kidney and, as a result, blood poisoning.
• Oncology or benign education. As a rule, cysts can increase the volume of tissue when they grow. The same applies to malignant tumors.

A decrease in the size of the kidney occurs with such pathologies:

• Chronic course of nephritis. So, if the disease was not detected at the very beginning and at the same time it passed into the chronic phase, the kidney will gradually give up its position, which will lead to organ failure. As a result, a non-functioning organ will shrink.
• dystrophic processes. Such an anomaly in the conclusion of the ultrasound is called kidney dysplasia.

kidney hump

The parameters of the urinary organ can sometimes change not only in size, but also in contours. Sometimes the left kidney is characterized by the so-called hump, that is, the protrusion of the contour of the organ outward. Initially, a specialist can define this as a cyst or other formation, but upon closer examination and against the background of normal echogenicity, it becomes clear that this is just a feature of the organ. That is, a humpbacked kidney is only a feature of the anatomy of a particular patient. Such a structure does not bear any complications. The body performs its function completely and does not violate the image and quality of human life.

Parenchymal changes on ultrasound

When examining the kidneys on ultrasound, a specialist can identify not only deviations from normal sizes, but also violations in the structure of the kidney tissue. In conclusion, the terms "reduced echogenicity" or "increased echogenicity" will be introduced. That is, some parts of the parenchyma or its entire structure change under the influence of the current pathology. In most cases, it is in the parenchyma that cysts, formations, abscesses are localized. However, even an ultrasound specialist does not include the term “tumor” in the research protocol. An accurate diagnosis is made only by a doctor, based on laboratory tests performed earlier and on the results of additional hardware studies.

Changes in the pelvis

As a rule, the only changes that can occur with the pelvis are thickening of their mucosa or the presence of stones / sand in them. In the first case, the mucous membrane of the pelvis increases with acute pyelonephritis or hydronephrosis. That is, the mucous membrane is inflamed due to overflowing with urine with the inclusion of pathogenic bacteria. If stones were localized in the pelvis, then this also indicates inflammation of the mucosa. In this case, the pelvis will be expanded.

Important: stones smaller than 2 mm are not visible on ultrasound. Echogenicity differs only in stones of larger diameter.

Kidney normal on ultrasound

• Renal tissue is homogeneous;
• Contours - smooth;
• The pelvis is free from stones and sand.

Terms of ultrasound

If you really want to understand before the visit to the attending physician what the specialist wrote there in the conclusion, then we offer a number of special terms that will help you understand the results of the examination. So, the most commonly used are:

• echogenicity. This is the reaction of the tissues of the internal organs to the conducted ultrasound. Echogenicity is expressed in the intensity of tissue darkening.
• fibrous capsule. Tissue surrounding the kidney.
• Pelvis. Organ cavity in which primary urine is collected.
• Microcalculosis. The presence of sand or small stones in the pelvis.
• Parenchyma. Kidney tissue.
• Inclusions. The presence in the tissues of the body of any formations (cysts, etc.).

Important: but, even having an ultrasound report in your hands and understanding, you should not make a diagnosis yourself. This is done only by the attending physician, who has the right to suspect or exclude pathology according to the patient's medical history.