Renal ultrasonography (Renal US) is the examination of one or both kidneys using medical ultrasound.Ultrasonography of the kidneys is essential in the diagnosis and management of kidney-related diseases. The kidneys are easily examined, and most pathological changes in the kidneys are distinguishable with ultrasound. US is an accessible, versatile inexpensive and fast aid for decision-making in patients with renal symptoms and for guidance in renal intervention. Renal ultrasound (US) is a common examination, which has been performed for decades. Using B-mode imaging, assessment of renal anatomy is easily performed, and US is often used as image guidance for renal interventions. Furthermore, novel applications in renal US have been introduced with contrast-enhanced ultrasound (CEUS), elastography and fusion imaging. However, renal US has certain limitations, and other modalities, such as CT and MRI, should always be considered as supplementary imaging modalities in the assessment of renal disease.

The ultrasonic renal exam does not require any preparation of the patient and is usually performed with the patient in the supine position. The kidneys are examined in longitudinal and transverse scan planes with the transducer placed in the flanks. When insonation of the kidney is obscured by intestinal air, the supine scan position is combined with the lateral decubitus position with the transducer moved dorsally. Preferably, the exam is initiated in the longitudinal scan plane, parallel to the long diameter of the kidney, as the kidney is easier to distinguish.

In the adult patient, a curved array transducer with center frequencies of 3–6 MHz is used, while the pediatric patient should be examined with a linear array transducer with higher center frequencies. Artifacts of the lowest ribs always shadow the upper poles of the kidneys. However, the whole kidney can be examined during either normal respiration or breath hold, as the kidney will follow the diaphragm and change position accordingly.

In the longitudinal scan plane, the kidney has the characteristic oval bean-shape. The right kidney is often found more caudally and is slimmer than the left kidney, which may have a so-called dromedary hump due to its proximity to the spleen. The kidney is surrounded by a capsule separating the kidney from the echogenic perirenal fat, which is seen as a thin linear structure.

Journal of Imaging and Interventional Radiology is the peer-reviewed journal of choice for interventional radiologists, radiologists, cardiologists, vascular surgeons, neurosurgeons, and other clinicians who seek current and reliable information on every aspect of interventional radiology.
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Best wishes

Ann Jose

Journal coordinator

Journal of Imaging and Interventional Radiology

intervradiology@longdomjournal.org