Ultrasound in experimental and clinical renal vein thrombosis.

Abstract

Static ultrasound was used to study 5 dogs with surgically produced unilateral renal vein thrombosis and 8 patients with unilaterally occluded renal veins. In both clinical and experimental situations, renal vein thrombosis acutely led to decreased cortical echogenicity and nephromegaly. Between 10 days and 3 wk, there was an increase in cortical echogenicity with preservation of corticomedullary definition. The late changes were decreased renal size, increased cortical echogenicity and loss of corticomedullary definition. Histologic examination showed a significant deposition of collagen within the cortex and medulla of the dogs'' kidneys during the late stage of the disease. Real time ultrasonography in 2 dogs and in 1 [human] patient during acute renal vein thrombosis demonstrated absence of transmitted pulsations to the affected renal vein. Doppler ultrasound in 1 patient with proved renal vein thrombosis demonstrated absence of flow. The differential diagnosis and significance of the ultrasound findings are discussed.