Ultrasound images of Multicystic dysplastic kidney (MCDK)

The MCDK is generally the result of complete, early ureteric obstruction in utero before 10 weeks,
and is frequently diagnosed antenatally. The resulting kidney is non-functioning and contains cysts of
varying sizes, separated by echogenic ‘dysplastic’ renal parenchyma. In general the cysts do not communicate but occasionally some communication can be seen, making differentiation from a severe
hydronephrosis difficult.
MCDK is usually unilateral and is considered a benign condition, although there is a slight risk of
malignancy and hypertension in later life. The kidney gradually involutes and often completely disappears
(Fig. Ultrasound images below)
ultrasound images Multicystic dysplastic kidney
This ultrasound images multicystic dysplastic kidney, diagnosed antenatally, has shrunk to little over 2 cm in length by the age of 1 year. Surgical removal is unnecessary unless symptomatic due to its large size or is associated with repeated episodes of infection. Provided the contralateral kidney is normal, with good function, the prognosis is good. There is, however, an increased risk of associated urinary tract anomalies, such as ureterocoele, vesicoureteric reflux or contralateral pelviureteric junction obstruction, which may predispose to infection. These can be demonstrated with ultrasound and micturating cysto-urethrogram.
A DMSA scan differentiates MCDK, which is completely non-functioning, from a grossly hydronephrotic kidney, a distinction which may sometimes be difficult to make on ultrasound. Follow-up ultrasound scanning is generally advised in view of the slight increased risk of Wilms’ tumour and to monitor the growth of the contralateral kidney.
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