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The kidney is surrounded by a capsule separating the kidney from the echogenic perirenal fat, which is seen as a thin linear structure. [1] The kidney is divided into parenchyma and renal sinus. The renal sinus is hyperechoic and is composed of calyces, the renal pelvis, fat and the major intrarenal vessels.
The renal fascia separates the adipose capsule of kidney from the overlying pararenal fat. The deeper layers deep to the renal fascia are, in order, the adipose capsule (or perirenal fat), the renal capsule and finally the parenchyma of the renal cortex. [2] At the renal hilum, the renal capsule extends into the renal sinus. [1]
The renal sinus is a cavity within the kidney which is occupied by the renal pelvis, renal calyces, blood vessels, nerves and fat. The renal hilum extends into a large cavity within the kidney occupied by the renal vessels, minor renal calyces, major renal calyces, renal pelvis and some adipose tissue .
The renal capsule surrounds the functional tissue of the kidney, and is itself surrounded by a fatty adipose capsule, fascia, and fat. From the inner part of the kidney to outside the kidney, the positioning of the capsule is: renal medulla; renal cortex; renal capsule; adipose capsule of kidney (or perirenal fat, or perinephric fat) renal fascia
Upon presentation of decreased renal function, it is recommended to perform a history and physical examination, as well as performing a renal ultrasound and a urinalysis. [ citation needed ] The most relevant items in the history are medications , edema , nocturia , gross hematuria , family history of kidney disease, diabetes and polyuria .
Abdominal ultrasound can be used to diagnose abnormalities in various internal organs, such as the kidneys, [1] liver, gallbladder, pancreas, spleen and abdominal aorta.If Doppler ultrasonography is added, the blood flow inside blood vessels can be evaluated as well (for example, to look for renal artery stenosis).
Ultrasound is standard and is particularly sensitive to the fat in angiomyolipomas, but less so to the solid components. However, accurate measurements are hard to make with ultrasound, particularly if the angiomyolipoma is near the surface of the kidney (grade III). [4] CT is very detailed and fast, and allows accurate measurement.
For incidentally detected prenatal hydronephrosis, the first study to obtain is a postnatal renal ultrasound, since as noted, many cases of prenatal hydronephrosis resolve spontaneously. This is generally done within the first few days after birth, although there is some risk that obtaining an imaging study this early may miss some cases of ...