1) Should be able to identify stone – hypoechoic shadow is a clue

2) Should be able to identify ADPKD, Aquired cystic disease of dialysis (history will be helpful), Benign cyst and RCC  – Understanding Bosniak classification of cyst is helpful for diagnosis

3) Irregular margin and contrast enhancing cyst is RCC

4) US screening for Renal artery stenosis –  RA/A >3.5/1

RA velocity>2mps

It is also useful to understand the downstream waveform in the lobar and lobular arteries- Tardus parvus waveform and loss of ESP(early systolic peak) notch suggests significant RAS

5) Should be able to identify hydronephrosis

6) RI in normal kidney is<75 and Transplant kidney is<80  . RI is systolic/systolic +diastolic flow. RI of1 indicates no diastolic flow.

7) Granulomatous pyelonephritis – easily identified. Needs nephrectomy!

8) Non contrast CT stone protocol has 98%PPV and 98%NPV

9) Calcification – Medullary calcification and cortical calcification is easily recognized by location. Irregular bilateral asymmetric medullary calcification is usually Medullary sponge kidney

10) In post transplant kidney – elevated RI and Elevated Peak systolic velocity in Renal artery >300 cm/sec doen not indicate stenosis and it should normalize within 72 hours of transplant.

 

These are some of the high yield points in imaging. Please tag other points you may consider worthwhile revising or for understanding.(tag to this post)

Yuvaraj