Clinical Study Of Ultrasound Diagnosis In Children With Renal Injury And Acoustic Imaging Experimental Study

Objective To analyze the imaging features and hemodynamic characteristics of the renal trauma in ultrasound,and to evaluate the sonography application in the renal trauma diagnosis. Methods To observe the size, shape, intra-echo and blood flow signal of the injured renal in 40 cases by two-dimensional sonography and Color Doppler ultrasonic apparatus, comparing the above with the corresponding health renal. The ultrasonic results were compared with CT or surgical findings. Results Among 40 cases of renal injures there were 31 cases with contusion of renal (77.5%), 4 cases with laceration of renal (10%) and 5 cases with fragmented injury of renal (12.5%). While in 3 cases with renal contusion, no evidence was noticed in the ultrasonic imaging, which confirmed by the CT scan. Renal contusion was showed as renal swelling, nearly normal or heterogeneous renal parenchyma echo by ultrasonic scan, meanwhile, as decreased or normal blood flow signal by color Doppler. Renal contusion detected by Color Doppler reflected decreased or normal blood flow signal. There were 2 cases with renal capsular laceration and 2 cases with renal subcapsular laceration among the 4 cases with renal laceration. The imaging of the renal capsular laceration showed the echo of capsular had been interrupted or vague. Also, the echo in renal parenchyma had been enhanced. There were irregular anechoic areas containing doted hyperechoic area in the adjoining parenchyma and perinephric space in the capsular lacerated renal. The imaging of the renal subcapsular laceration showed the echo of subcapsular successively and there were irregular anechoic areas containing doted hyperechoic area in the parenchyma. The boundary between the cortex and medulla of the renal with subcapsular laceration was vague. Moreover, the increased width of the renal collecting section and the echo separation of the renal sinus had been displayed. The renal fragmented injury appeared as increased size of the renal, vague capsular, irregular shape, destroyed structure was displayed as heterogeneous hyperechoic, hypoechoic and anechoic attern. By Color Doppler flow imaging the renal fragmented injuries were found scanty or absent blood flow signal. The ultrasonic imaging of 30 cases out of 33 without operation was coincided with the finding by CT scan. For the 7 cases received surgical treatment, the image of the ultrasound had been confirmed in operation . Conlusion Sonography was able to present the renal structure and blood supply in real time and determined the degree and the area of the renal trauma. The results indicated that the sonography investigation could play important role in the diagnosis of the renal trauma, and be helpful to provide imaging evidence for the clinical treatment in children.