Gray scale&Doppler ultrasound Cases.

12/12/2025

Emphysematous Pyelonephritis (EPN) – Ultrasound
65 years old patient came with Diabetes and High level of boold urea and blood creatinine.

Presenting Symptoms: Fever, flank pain, dysuria, nausea.

1️⃣ Definition

A severe, necrotizing, gas-forming infection of the renal parenchyma, most commonly seen in patients with diabetes mellitus or urinary tract obstruction. Early diagnosis is crucial to prevent sepsis and renal failure.
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2️⃣ Ultrasound Findings

1_Enlarged kidney

2_Loss of corticomedullary differentiation

3_Multiple highly echogenic foci in renal parenchyma

4_Dirty shadowing / reverberation artifacts indicating intraparenchymal gas

5_Hypoechoic, swollen renal cortex

6_Reduced or absent blood flow in necrotic areas on Doppler.

21/11/2025

Bilateral undescended abdominal te**es.
Ultrasound Finding.

Both te**es are not visualized within the scrotal sac.

Two oval hypoechoic structures consistent with te**es are identified within the lower abdomen, located Around the Illiac Artery and superior to the inguinal canals.

05/11/2025

🧠 Polycystic Kidney Disease with Seminal Vesicle Cysts

📍 Ultrasound Findings & Clinical Notes

🩺 Ultrasound Findings:

Kidneys: Enlarged with multiple variable-sized cysts scattered in both cortices and medullae.

Seminal Vesicles: Enlarged, containing simple or septated cystic areas, usually bilateral.

No internal vascularity on color Doppler.

🧬 Clinical Note:
This represents an extrarenal manifestation of autosomal dominant polycystic kidney disease (ADPKD).
Seminal vesicle cysts may cause obstructive azoos***mia, low ej*****te volume, or even infertility due to ejaculatory duct obstruction.

23/10/2025

A well-defined regular-outlined complex mass with heterogeneous texture in the right lobe of liver.

11/10/2025

06/10/2025

Spermatocele = Cystic dilatation of the epididymal duct containing s***matozoa seen in superior pole of te**is.

Ultrasound finding
_______________________
Cystic lesion in epididymal head

Fine low-level echoes inside (s***m content)

No internal vascularity on Doppler

the Difference between epididymal cyst and s***matocele Just Internal Echose that seen in the s***matocele.

02/10/2025

one of the most Common Congenilat anomalies of kidneys are Horseshoe kidneys. (کلیه نعل اسپی )

The most common complication of horseshoe kidney is ureteropelvic junction (UPJ) obstruction, followed by urinary tract infections and renal stones.

27/09/2025

Patient with Amenorrhea, abdominal pain and spotting Vaginal bleeding.

Ultrasound Finding.
Direct signs (specific):

__Tubal ring sign → hyperechoic ring with hypoechoic center in adnexa.
Ring of Fire sign = Peripheral circumferential vascularity around adnexal mass on Color Doppler, showing low-impedance flow.

__Extrauterine gestational sac with yolk sac or embryo.

__Fetal pole with cardiac activity outside uterus.

Indirect signs (suggestive):
____________________________
Empty uterus with β-hCG above discriminatory zone.

Adnexal complex mass (heterogeneous echogenicity).

Free fluid in cul-de-sac (Pouch of Douglas)

Hemoperitoneum → large amount of free intraperitoneal fluid with internal echoes

25/09/2025

A 30-years-old man presented with a history of infertility.
Epididymal ectasia was Diagnosed In Scrotal ultrasound.

Ultrasound Findings.
_______________________________________
- Dilated tubules in the epididymal head, body, or tail.
- Appears as multiple anechoic tubular.
- No internal vascularity within the dilated ducts
- May be unilateral or bilateral

- Often associated with.

- History of infection, trauma, or vasectomy
__blockage of Dactus deferens.

24/09/2025

A 70 years old patient presented with Dysuria and History of Radical prostatectomy.

Ultrasound finding was.

_Urinary bladder wall mass.
_Urinary bladder Diverticulum.
آدرس افغانستان _هرات شفاخانه ماهان، وارد یورولوژی _ التراسوند