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Methodology of ultrasound of kidneys and ureters
Last reviewed: 06.07.2025
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Kidney and Ureters Scanning Technique
The right kidney is visualized with the patient in a supine position, using the liver as an acoustic window.
Scanning is always done with a deep breath hold: ask the patient to take a deep breath and hold it. Remember to tell the patient to relax and breathe normally afterwards.
Begin with a longitudinal scan across the anterior abdominal wall of the upper right abdomen, then move to a transverse scan. Then turn the patient to the left lateral position to visualize the right kidney in a frontal view.
To visualize the left kidney, apply the gel to the skin of the left upper abdomen. Scan the left kidney in the same sequence.
If the left kidney is not visualized (usually due to flatulence), try to conduct the examination with the patient lying on the right side.
Intestinal gas can also be displaced by drinking 3-4 glasses of water. The left kidney can then be visualized through the fluid-filled stomach with the patient lying on his back.
If you cannot get an adequate image of the kidneys, scan through the lower intercostal spaces. Turn the patient on his stomach and apply gel to the kidney area on the right and left. Make longitudinal and transverse sections along the entire kidney area.
Both kidneys can be examined with the patient sitting or standing.
Whichever position is used, remember that both longitudinal and crosswise cuts must be made.
When examining the kidneys, it is very important to evaluate the symmetry of the kidneys. Differences in size, contour condition and internal echostructure may indicate the presence of pathology.
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