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Color Doppler sonographic findings in renal vascular lesions
R R Sullivan1, M B Johnson, K P Lee
1Department of Radiology, University of Southern California School of Medicine, Los Angeles 90033.
Insights
Color Doppler sonography effectively identified renal vascular lesions, including arteriovenous fistulas and pseudoaneurysms, even when other imaging missed them. This technique shows promise for diagnosing complex renal vascular conditions.
Area of Science:
- Radiology
- Vascular Imaging
- Medical Diagnostics
Background:
- Renal vascular lesions, such as arteriovenous fistulas and pseudoaneurysms, can be challenging to diagnose.
- Conventional imaging techniques may not always detect these subtle vascular abnormalities.
Observation:
- Color Doppler sonography was used to evaluate three patients with renal vascular pathology.
- One patient had a congenital arteriovenous (AV) fistula, and two had renal pseudoaneurysms.
- The AV fistula was initially missed by real-time sonography and computed tomography.
Findings:
- Color Doppler sonography detected the AV fistula, characterized by high-frequency shift blood flow within a hypoechoic lesion.
- Both renal pseudoaneurysms exhibited bidirectional swirling blood flow within an anechoic component of a complex mass.
- Angiography or pathology confirmed the sonographic findings in all three cases.
Implications:
- Color Doppler sonography demonstrates significant potential for evaluating renal vascular pathology.
- This imaging modality can aid in the accurate diagnosis of renal arteriovenous fistulas and pseudoaneurysms.
- Enhanced visualization of blood flow dynamics improves diagnostic confidence in renal vascular assessments.
Abstract:
Three patients with renal vascular lesions, one congenital arteriovenous (AV) fistula and two renal pseudoaneurysms, were assessed with color Doppler sonography. The AV fistula was detected initially by color Doppler after having been missed by both real-time sonography and computed tomography. High frequency shift blood flow within a hypoechoic lesion noted by color Doppler characterized the AV communication. Both renal pseudoaneurysms had detectable bidirectional swirling blood flow within an anechoic portion of a complex mass. Findings in all three cases were confirmed by angiography or pathology. Color Doppler sonography seems potentially useful in the evaluation of renal vascular pathology.