60-year-old male with history of renal transplant presents with AKI. RENAL TRANSPLANT: Measures approximately 11.9 cm. There is a heterogenous echotexture of the parenchyma with poor corticomedullary differentiation.LOCATION: Left iliac fossa.PERITRANSPLANT TISSUES: Small amount of perinephric fluid measuring approximately 5.8 x 1.4 x 1.9 cm.COLLECTING SYSTEM/URETER: No significant abnormality notedURINARY BLADDER: The bladder is nondistended.VASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels The left renal artery anastomosis area has a peak systolic flow of 93.2 cm/s and resistive index of 0.84.The mid renal artery had a peak systolic flow 102 cm/s and a resistive index of 0.88.The hilum had a peak systolic flow of 65 cm/s with a resistive index of 0.94.The mid segmental artery had a peak systolic flow 110 cm/s the resistive index of 1.0The mid arcuate artery has a peak systolic flow 35 cm/s resistive index of 1.0.The renal vein is patent without evidence of thrombus.OTHER: No significant abnormality noted
1. Heterogenous echotexture parenchyma and increased resistive indices of the arcuate and segmental arteries most consistent with parenchymal dysfunction. Consider acute tubular necrosis or rejection. Renal vein thrombosis less likely given the renal vein is patent.Findings were discussed with Dr. Wright @ 2250 on 08/21/16 by the on call radiology resident.