Ultrasound images of (thickening of the PCS walls) kidneys

These are varied and non-specific. In the majority of cases the kidney appears normal; however, greyscale findings include enlargement due to oedema (this change is subtle in the early stages and not a reliable ultrasonic indicator), increased corticomedullary differentiation with prominent pyramids, infundibular thickening (thickening of the PCS walls) and decreased fat in the renal sinus (Fig.ultrasound images below).
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Ultrasound images Transplant rejection: peri-infundibular thickening (arrows) is demonstrated and the renal parenchyma looks abnormally hyperechoic with increased corticomedullary differentiation These findings are subjective, non-specific and limited in the diagnosis of rejection. In chronic rejection there may be an overall increase in the echogenicity of the kidney with reduced corticomedullary differentiation. Eventually the kidney will shrink. The Doppler resistance indices are increased in rejection but, again, this finding is non-specific  (Fig. ultrasound images below). In general, the higher the RI or PI, the more likely is the diagnosis of acute rejection.
The cause of renal dysfunction is established by biopsy.
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Ultrasound images of The Doppler indices are raised in this rejecting kidney, with
no EDF. Loss of corticomedullary differentiation is noted in the kidney.
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