Thickening of the renal collecting system: a nonspecific finding at US.

Abstract

The records of 22 patients in whom wall thickening of the renal collecting system was seen at ultrasound (US) were retrospectively reviewed. Wall thickening was found in 15 patients with renal transplants and seven with native kidneys. Severe thickening occurred with transplant rejection, but thickening also occurred with urinary tract infection, reflux, or chronic obstruction in both transplanted and native kidneys. As such, thickening of the renal collecting system seen at US is a nonspecific finding that must be correlated with the clinical and laboratory findings.

Pelvocalyceal thickening in HIV-associated nephropathy

“…Previously reported causes of PCT [9][10][11][12][13][14] were excluded in all 15 patients with HIVAN, among whom PCT was bilateral in 14 (93%). Eight (53%) were HIVAN was 1.7 years (SD = 2.1; range, 0-8).…”

“…Renal PCT is now known to be a nonspecific finding that can be seen sonographically with infection, acute tubular necrosis, vesicoureteral reflux, obstruction, chemotherapy, and urological surgery [9][10][11][12][13][14]. In most reported cases the finding has been unilateral, although occasionally PCT has been noted in both kidneys [13,14].…”

“…Pelvocalyceal thickening (PCT) is a nonspecific sonographic finding that in native kidneys has been associated with acute tubular necrosis, infection, reflux, urological surgery, obstruction, and chemotherapy [9][10][11][12][13][14]. Most reports have described this as a unilateral finding.…”

Computed tomography of pyonephrosis

“…The ultrasound findings of pyonephrosis enumerated previously have included diffuse and gravity-dependent echoes within the pelvicalyceal system [6][7][8], shadowing peripheral echoes secondary to gas from gas-forming organisms [6], and renal collecting system wall thickening [5,9].…”

“…Wall thickness was classified based on a modification of the Nicolet et al system [5]: none, imperceptible wall thickness; grade 1, -<2 mm; grade 2, 3-5 mm; and grade 3, >5 ram. To eliminate confusion between the renal pelvic wall and adjacent blood vessels, wall thickness grades were assigned only when a perceptible wall was present around most of the perimeter of the renal pelvis.…”