Urogenital ImagingNephrocalcinosis
the term used for radiologically demonstrable
diffuse fine parenchymal (noncalyceal)
renal calcification. In nephrology, the term is often restricted to the description of calcifications in the medullary region only. Some of the common causes are
hypercalcaemia renal involvement or hypercalciuria (
hyperparathyroidism,
renal tubular acidosis,
milk alkali syndrome,
Cushings syndrome,
hypervitaminosis D,
sarcoidosis, bone metastases, multiple myeloma),
oxalosis,
medullary sponge kidney, chronic
glomerulonephritis. In children the most common causes are primary
renal tubular acidosis and primary hyperoxaluria. The
calcification is most pronounced in the region of the
renal pyramids, although, in more severe cases,
calcification may also be demonstrated in the cortex.
On plain films, renal parenchymal calcifications are seen, usually bilateral and diffuse. Sonographically, calcific areas appear as echogenic foci with posterior acoustic shadowing (Fig.1). Noncontrast CT scans can also detect these calcifications. Of these imaging techniques, CT is the most sensitive and accurate, making it the modality of choice.
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Longitudinal ultrasound image of the right kidney showing multifocal nephrocalcinosis.
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Nephrocalcinosis, Fig.1 | |