[Difficulty in the differentiation of renal parenchymal hyperechogenicity]

One hundred patients were examined: 70 with diffuse increased parenchymal echogenicity and 30 with focal increased echogenicity. The increase of echogenicity was assessed in degree and in diffuse increased parenchymal echogenicity were considered persistence or disappearance of the corticomedullary boundary. An increased diffuse echogenicity with distinctness of the corticomedullary boundary was observed in chronic GNF (36), nephroangiosclerosis (15) and amyloidosis. Diffuse increased echogenicity without distinctness of the corticomedullary boundary was observed in uratic interstitial nephropathy (13) and in chronic GNF with advanced lesions (4). Focal increased echogenicity occurred in chronic pyelonephritis (11), in tumors (18) and in renal tuberculosis (1). Renal carcinomas showed an echogenicity of I degree in 7 cases and an echogenicity of II degree in 1 case. The angiomyolipomas always showed an echogenicity of II degree, as did the liposarcoma. Differential diagnosis among parenchymal renal diseases which are responsible for diffuse increased echogenicity is impossible; in fact there is no correlation between the degree of renal parenchymal echogenicity and type of the disease. The focal increased echogenicity caused by chronic pyelonephritis is correctly diagnosed using ultrasound. The hyperechogenic tumors, at present, cannot be characterized on the basis of the sonographic features.