Learning objectives
To demonstrate the proper techniques and protocols for renal Doppler evaluation.
To explain the B-mode examination,
"Money views" and Parameters adjustment.
To gain knowledge of the Direct and Indirect examination of the renal arteries.
To know the criteria for renal artery stenosis and renal vein thrombosis.
The evaluation of renal stents.
Background
Duplex Doppler sonography is now considered the main screening tool for renovascular disorders because it provides data about the presence and direction of renal arterial and venous blood flow and resistance.
Duplex Doppler sonography scanning is technically difficult,
and it needs a considerable amount of skill due to the depth of the examined arteries,
presence of bowel gas and motion due to respiration.
The patients should therefore be examined preferably after a 12-h overnight fast in order to reduce bowel gas.
Findings and procedure details
Patient positioning:
The patient should be in supine position with the bed elevated around 30º.
A low-frequency transducer (2.5-5.0 MHz) is used to identify the abdominal aorta and renal arteries.
The important views “Money views” are: oblique view through the liver for the right renal artery,
lateral decubitus for the left renal artery.
Also,
the anterior approach is used to evaluate the main RA,
in selected cases the posterior approach can be used.
Parameters adjustment:
Doppler gain should be adjusted by increasing the gain to...
Conclusion
Color-Doppler US is a noninvasive,dynamic,
real-time,
repeatable,
inexpensive diagnostic procedure which can accurately screen for renovascular diseases if performed by an expert.
References
1. Zubarev AV.
Ultrasound of renal vessels.
Eur Radiol 2001;11:1902e15.
2. Krumme B.
Renal Doppler sonography e Update in clinicalnephrology.
Nephron Clin Pract 2006;103:c24e8.
3. Moghazi S,
Jones E,
Schroepple J,
et al.
Correlation of renal histopathology with sonography findings.
Kidney Int 2005;67: 1515e20.
4. Bude RO,
Forauer AR,
Caoili EM,
Nghiem HV.
Is it necessary to study accessory arteries when screening the renal arteries for renovascular hypertension? Radiology 2003;226:411e6.
5. Meola M,
Petrucci I.
Color Doppler sonography in the study of chronic ischemic nephropathy....