Ultrasound images of Vesicoureteric junction

The normal ureters may be identified on ultrasound with high-resolution equipment, as they enter the
bladder. Jets of urine emerge into the bladder at these points and can be demonstrated with colour
Doppler. An absent or reduced number of jets may indicate obstruction on that side; this finding again
should be interpreted cautiously. Ureteric jet analysis is not routinely performed at most hospitals
as a diagnostic test of renal obstruction. Careful scanning at the VUJs can identify significant
anomalies (Figs ultrasound images below):
● Reflux can be seen to dilate the ureter intermittently (see below).
● A ureterocoele may be diagnosed as it dilates with the passage of urine; it may not be obvious until
the operator has watched carefully for a few minutes.
● Stones may become lodged at the VUJ, causing proximal dilatation.
image
Ultrasound images Hydronephrosis of the right kidney. The kidney however is small at 7.2 cm, the cortex echogenic and thinned, particularly at mid pole level. Appearances suggest this appearance is chronic.
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Ultrasound images  TS of a left-sided hydronephrosis. Echogenic material is present within the collecting system. The patient was pyrexial. Pus was drained.
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