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Joseph Junewick, MD FACR
over 7 years ago
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Renal Vein Thrombosis

Case Detail

Anatomy: Genitourinary
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Vascular
Created: over 4 years ago
Updated: over 4 years ago
Tags: PEDS
Modality/Study Types: US
Activities:
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History

Newborn with perinatal asphyxia, oliguria and hematuria.


Case Images


Diagnosis

Renal Vein Thrombosis

Findings

US – Branching interlobular echodensities with absent diastolic flow on spectral Doppler.

Discussion

Renal vein thrombosis may be related to maternal diabetes, dehydration, shock, sepsis, polycythemia or coagulopathy. The sonographic features vary according to the severity, the extent of the thrombus, the development of collateral circulation and the stage of renal vein thrombosis. Initial diagnostic features include, renal enlargement, echogenic medullary streaks that have a vascular or perivascular distribution, thrombus in the vein, accentuated followed by loss of corticomedullary differentiation, reduced echogenicity around the affected pyramids and echogenic band at the extreme apex of the pyramid. High RI or loss of diastolic flow and loss of renal vein phasicity on Doppler are also signs. While sonography may be useful in the diagnosis of renal vein thrombosis, there are no characteristic grey-scale or Doppler ultrasound prognostic features to predict outcome.

Reference

Elsaify WM. Neonatal renal vein thrombosis: grey-scale and Doppler ultrasonic features. Abdom Imaging (2009); 34(3):413-418.



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