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Radiology
Multicystic Dysplastic Kidney
Built from Obstetric Imaging
What’s inside
10 sections · 64 slides
Overview
- The whole idea in one slide
- What we will work through
What a multicystic dysplastic kidney is
The definition, how common it is, and the words behind the name
- The definition, piece by piece
- Normal kidney beside a kidney replaced by cysts
- Reading the name
- The affected tissue does no work
- 1:3000–4000
- How common it is
Why it happens
How a kidney is normally built, and what happens when the build fails
- How a kidney is normally built
- The two partners in that build
- Where the build fails
- A second explanation
- Is it inherited?
- Genetic conditions that look the same
What it looks like on ultrasound
The classic sign, and how much the picture can vary
- The classic sign
- Why cysts look black on a scan
- One-sided dysplastic kidney beside a normal kidney
- What to notice in those two panels
- No artery reaching the cystic kidney
- The size is not fixed
- Both kidneys filled with very large cysts
- Measuring the enlarged kidney
- What that scan is telling you
- Both kidneys with smaller cysts and bright tissue
- Two faces of the same diagnosis
- A term worth defining
- Unusual patterns
The other kidney
When one side is dysplastic, the healthy side decides the outcome
- Why the other kidney is everything
- What is usually wrong with the other kidney
- Reflux, in plain words
- Junction obstruction, in plain words
- Watch the renal pelvis
- The healthy kidney changing over eight weeks
- Bladder, ureter, pelvis and calyces labelled
- What changed between the two scans
- Compensatory hypertrophy
- Fluid and anomalies elsewhere
When both kidneys are affected
No urine, no amniotic fluid, and lungs that cannot grow
- Where amniotic fluid comes from
- From two bad kidneys to a lethal outcome
- Naming that chain of events
- Is there any treatment before birth?
- The rare exceptions
Making the diagnosis
How reliable the scan is, and what to do once you see it
- 98%
- Reading those two numbers
- What to do once you suspect it
- Why each step is there
- The point of the late scan
What else it could be
The look-alikes on ultrasound, and the syndromes behind some of them
- The main look-alikes
- Swollen drainage spaces, not cysts
- Many small cysts with the drainage system intact
- Syndromes that include cystic kidneys
- More syndromes on that list
- Why the inheritance pattern matters
After birth
From routine surgery to routine watching, and why the thinking changed
- The first steps after delivery
- Surgery: then and now
- What surveillance means
- Many of them simply shrink away
The bottom line
What to tell the referring doctor, and what to remember
- What the referring physician needs to know
- Key points to carry away
- Three questions to answer on every scan
- References
- References (continued)
- References (continued)
- Obstetric Imaging: Fetal Diagnosis and Care, 2nd Edition