Sequential sonographic features in neonatal renal vein thrombosis

Area of Science:

• Neonatal Medicine
• Pediatric Radiology
• Vascular Imaging

Background:

• Renal vein thrombosis (RVT) is a rare, acute, and serious condition in newborns.
• Clinical presentations of RVT range from mild symptoms to life-threatening emergencies.
• Imaging, particularly sonography, is crucial for diagnosing RVT in neonates.

Purpose of the Study:

• To present retrospective sequential ultrasonic imaging findings in neonates with RVT.
• To highlight the evolution of specific sonographic features in each phase of RVT.
• To emphasize the importance of recognizing these features for timely diagnosis.

Main Methods:

• Retrospective analysis of sequential ultrasonic imaging.
• Inclusion of three neonatal patients (two term, one preterm) with characteristic RVT findings.
• Utilized gray-scale, color, and spectral/power Doppler ultrasound.

Main Results:

• Key initial ultrasound findings include renal enlargement and echogenic medullary streaks.
• Absence of arcuate vessel flow patterns, loss of corticomedullary differentiation, and altered echogenicity around pyramids were observed.
• Doppler signs like higher resistance index or reduced pulsatile venous flow in the affected kidney are significant.

Conclusions:

• Prompt diagnosis of RVT in neonates is essential.
• Understanding the specific sonographic features across different phases of RVT evolution is critical.
• Sequential ultrasound imaging plays a vital role in identifying and monitoring neonatal renal vein thrombosis.