November 21, 2011

Renal Scarring

A longitudinal ultrasound image of the kidney shows a focal depression of the lower pole cortex (arrows) with focal parenchymal thinning and a caliceal stone (between calipers).

Facts:
  • Renal scar is a common incidental finding during imaging of the GU tract
  • It can occur both with and without episodes of infundibular obstruction
  • Reflux is considered a major contributor in development of non-obstructive scarring, particularly in children with vesicoureteric reflux (VUR)
  • In adults, renal scarring is more associated with renal stone disease, either with stone or history of stone
Imaging
  • Focal cortical thinning and depression of the cortex, overlying the pyramid on any imaging modalities (IVU, US, CT, MR)
  • Hyperechoic band is seen over the parenchymal thinning on US
  • Mimic = normal renal lobulation. Lobulation will span the pyramids with echogenic lobular junctions into renal columns
Reference:
Newhouse JH, Amis, Jr, ES. The relationship between renal scarring and stone disease. AJR 1988; 151:1153-1156.

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