Presentation
Anhydramnios in utero
Patient Data
Images1,2 (left kidney) and images 3,4 (right kidney).
Bilaterally enlarged kidneys (11 cm long) with mild pelvicalyceal dilatation.
Innumerable punctate echogenic foci with comet tail artifact in the renal pyramids.
Sparing of the renal cortex appearing as a hypoechoic rim.
Case Discussion
The patient had autosomal recessive polycystic kidney disease and consanguineous parents. Unfortunately, the patient passed away due to complications from pulmonary hypoplasia.
The hyperechoic renal pyramids with comet tail artifacts represent ectatic collecting ducts appearing as numerous cylindrical cysts. A higher frequency linear probe may allow these cysts to be seen. Instead, the close proximity of the cysts causes them to appear as multiple punctate echogenicities.