71-year-old male. Assess change in left lower pole complex cyst. GFR 37. Contrast relatively contraindicated. RIGHT KIDNEY: The right kidney measures 9.8 cm in length. No hydronephrosis. Increased echogenicity of the renal parenchyma. Multiple renal cysts are again seen. The largest cyst on the right measures 6 x 6.5 x 7.3 cm (prior 6.1 x 6.3 x 6.1 cm). LEFT KIDNEY: The left kidney measures 12.1 cm in length. No hydronephrosis. Increased echogenicity of the renal parenchyma. Left lower pole heterogenous lesion measuring 1.3 x 1.2 x 1.3 cm (prior 1.5 x 1.3 x 1.4 cm).URINARY BLADDER: The urinary bladder is collapsed and incompletely evaluated.OTHER: No significant abnormalities noted.
Stable appearance of the left lower pole heterogenous lesion. Further evaluation with dedicated CT or MRI is recommended (half dose contrast administration is available for GFR between 30 and 60).