Renal Medullary Rim Sign: Ultrasonographic Evidence of Renal Disease

Biller, David S.; Bradley, Gregory A.; Partington, Beth P.

doi:10.1111/j.1740-8261.1992.tb00145.x

Cited by 43 publications

(51 citation statements)

References 7 publications

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“…Medullary rim signs occur in the outer zone of the renal medulla, parallel to the cortico-medullary junction and may be an incidental finding in the domestic cat and dog, 39 but may also be indicative of hypercalcemic nephropathy, chronic interstitial nephritis, leptospirosis, and acute tubular necrosis. [39][40][41] Although histopathology was not performed on the kidneys to determine normality, we speculate that the cortico-medullary rims seen in this study, which occur at the junction of the cortex and medulla, are probably incidental. The large variation in bladder length was most likely a result of the filling status of the bladder.…”

Section: Discussionmentioning

confidence: 99%

ULTRASONOGRAPHY OF THE LIVER, SPLEEN, AND URINARY TRACT OF THE CHEETAH (ACINONYX JUBATUS)

Carstens

Kirberger

Spotswood

et al. 2006

Vet Radiology Ultrasound

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Diseases of the abdomen of the cheetah (Acinonyx jubatus) include those affecting the liver, spleen, and urinary tract. The most common diseases of captive-bred cheetah are gastritis, gastric ulceration, glomerulosclerosis, and hepatic veno-occlusive disease, and are the most frequent causes of mortality in these animals. The purpose of this study was to describe the ultrasonographic anatomy of the normal liver, spleen, kidney, and urinary bladder of the anesthetized captive-bred cheetah. Twenty-one cheetahs were examined. Eight of the 21 animals had subclinical evidence of either gastritis or chronic renal disease. The ultrasonographic appearances of the liver, gall bladder, common bile duct, and spleen were evaluated and various measurements made. Statistical analyses of the measurements were performed on all the healthy and subclinically ill animals taking sex, age, mass, and anesthetic protocol into account. There were no significant differences in any parameters between the healthy and subclinically ill animals (P > 0.25) and data were combined for statistical analyses. The mean mass was 41.1kg ( +/- 8.8) and the mean age was 5.0 years (+/- 2.2). The mean thickness of the liver medial to the gall bladder was 67.0 mm (+/- 14.8) and the liver was within the left costal arch in 75% of animals, extended caudal to the right costal arch in 50% of animals for an average of 30 mm, and extended caudal to the sternum in 63% of animals for an average of 32.5 mm. The maximum mean hepatic vein diameter at the entrance to the caudal vena cava was 8.6 +/- 2.8 mm; the mean diameters of the portal vein at the hilus and that of the caudal vena cava as it entered the liver were 7.5 +/- 1.6 and 9.9 +/- 4.1 mm, respectively. The mean diameter of the caudal vena cava was significantly affected by the type of anesthetic used (P < 0.10). The mass of the animals was significant in explaining the variance in maximum portal vein diameters (P < 0.10). The mean maximum velocity of the hepatic vein flow at the entrance to the caudal vena cava was 25.3 +/- 2.8 cm/s (n=4), the hilar portal vein was 11.7 +/- 3.3 cm/s (n=7), and the caudal vena cava was 33.8 +/- 19.8 cm/s (n=5). The mean maximum gall bladder length and width, and the mean common bile duct diameters were 44.6 mm (+/- 10.4), 23.3 mm (+/- 5.0), and 8.1 mm (+/- 2.4), respectively. Age was significant in explaining the variance in gall bladder lengths (P<0.10). Urinary tract ultrasonography was performed only in animals that had normal urea and creatinine levels (n=13). Renal cortico-medullary distinction was present in all kidneys and a cortico-medullary rim sign was seen in 21 of 26 kidneys. Mean kidney length, height, and width was 63.9 +/- 5.7, 38.1 +/- 5.2, and 42.1 +/- 5 mm, respectively. The average resistivity index was 0.58 (n=5). Mean urinary bladder length, height, and width were 57.0, 19.2, and 34.9 mm, respectively.

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Section: Discussionmentioning

confidence: 99%

ULTRASONOGRAPHY OF THE LIVER, SPLEEN, AND URINARY TRACT OF THE CHEETAH (ACINONYX JUBATUS)

Carstens

Kirberger

Spotswood

et al. 2006

Vet Radiology Ultrasound

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“…22 Focal parenchymal calcification may occasionally simulate calculi. Theoretically, an infarct can be differentiated from scarring due to pyelonephritis by the lack of pelvic and diverticular C cm D interstitial nephritis, and leptospirosis, and in normal dogs and cats 8,[75][76][77]80,81 (see Figure 16-17, B to E). 73 Older infarcts may have a wedge-shaped, hyperechoic appearance with a broader base at the surface of the kidney that narrows toward the corticomedullary junction ( Figure 16 -14).…”

Section: Focal Hyperechoic Areas In the Renal Cortexmentioning

confidence: 99%

Urinary Tract

Nyland¹,

Widmer²,

Mattoon³

2015

Small Animal Diagnostic Ultrasound

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“…Changes in echogenicity can be focal or diffuse and involve the renal cortex, medulla or both. A curvilinear pattern of increased echogenicity, termed the medullary rim sign, is seen as an echogenic line in the region of the outer renal medulla that is parallel to the corticomedullary junction . A halo of reduced echogenicity between the renal cortex and the medullary rim (hyperechoic line) has been described in some dogs and cats .…”

Section: Introductionmentioning

confidence: 99%

“…A curvilinear pattern of increased echogenicity, termed the medullary rim sign, is seen as an echogenic line in the region of the outer renal medulla that is parallel to the corticomedullary junction . A halo of reduced echogenicity between the renal cortex and the medullary rim (hyperechoic line) has been described in some dogs and cats . A medullary rim sign was initially described as an indicator of primary renal disease and seen in a variety of renal disorders .…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Appearance of the Outer Medulla in Dogs Without Renal Dysfunction

Hart

Winter

Conway

et al. 2013

Vet Radiology Ultrasound

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Ultrasound findings of the canine kidney include a hyperechoic cortex and a hypo to anechoic medulla. In this study, the sonographic appearance of the outer renal medulla in dogs without evidence of renal disease is described. Dogs that underwent abdominal ultrasound over a 6-month period were subjected to review and then divided into six groups based on body weight (kg): < 4.9, 5.0-9.9, 10-19.9, 20-29.9, 30-39.9, and ≥ 40. Chi-square analysis was used to determine if the frequency of a hyperechoic outer medulla was significantly different between weight groups, sex, and age (P-value < 0.05). Of the 145 dogs that met the inclusion criteria, 45 had a hyperechoic outer medulla relative to the cortex and inner medulla. In the remaining dogs, the outer medulla was isoechoic to the cortex. Dogs less than 5 kg had the highest frequency of a hyperechoic outer medulla (P < 0.0001) and dogs greater than 40 kg did not have a hyperechoic outer medulla (P < 0.0001). Sex had no influence on the presence or absence of the hyperechoic outer medulla; however, younger dogs were overrepresented (6.4 ± 0.6 years compared with 7.8 ± 0.4 years; P = 0.04). Ultrasound descriptions of the canine kidney have not taken into account the contributions of the renal cortex and outer medulla. Based on this study of dogs with no clinically significant renal disease, the outer medulla can be isoechoic or hyperechoic to the cortex and a hyperechoic outer medulla is more commonly seen in small breed dogs.

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Renal Medullary Rim Sign: Ultrasonographic Evidence of Renal Disease

Cited by 43 publications

References 7 publications

ULTRASONOGRAPHY OF THE LIVER, SPLEEN, AND URINARY TRACT OF THE CHEETAH (ACINONYX JUBATUS)

ULTRASONOGRAPHY OF THE LIVER, SPLEEN, AND URINARY TRACT OF THE CHEETAH (ACINONYX JUBATUS)

Urinary Tract

Ultrasound Appearance of the Outer Medulla in Dogs Without Renal Dysfunction

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