Lecture 2


By Leandro Fernandez, MD.
Director, Advanced Vascular Ultrasound Laboratory (LEAV), La Floresta Medical Institute. Director, Ultrasound Department of Vista Alegre Private Hospital. Director-Instructor, SonoImagen – International School for Advanced Ultrasound affiliated to Jefferson Ultrasound Research and Education Institute (JUREI).

Three-dimensional ultrasound (3DUS) of the kidney is a new application recently used in clinical practice. Actually different clinical assays are ongoing to determine the efficacy of this new technology.

In our particular case, we have used this new technique in all the existing modalities since 1997. We have done initially renal 3D Power Doppler and then we have reconstructed the renal images to present them in three different ways: multi-plane, echo-tomography, and volume rendering.

3D Power Doppler is enormous usefully to observe the renal vascular tree, to see the spatial distribution of the renal vessels and to determine the flow of the minimal cortex renal arteries. These findings are excellent signs for the diagnosis of renal infarction, artery stenosis, vein thrombosis, renal transplant rejection and also to evaluate the vascular anastomosis.

The three-plane presentation allows observing simultaneously the X, Y and Z planes, offering a virtual coronal view in a “cut” only obtained by the intraoperative approach, with a non-3D ultrasound system. The three-plane presentation has a great value to detect tumor masses, solids or cysts, and also to detail the fine internal structures. The interface of the renal capsule is better defined.

Niche-Mode or Echo-Tomography, the term that we prefer, present in the same image, the longitudinal, axial and coronal planes, doing a millimetric exploration of any lesion, allowing a stereotaxic localization and a better mass limits definition or renal stone visualization.

The volume rendering is the only way to see the 3D surface of cystic lesions and processing the echo data with the diverse digital tools, we can present the internal and the external surface to study their conditions. It is very useful to analyze complex cysts.

We will show all 3D modalities images in several renal conditions as lithiasis, cysts, tumors, and parenchymal diseases realized with our 3D Systems: the Voluson 530 Digital, ATL 5000 and the Advanced 3DI Silicon-Graphics Work Station.


These are the latest technologies and developments in 3D Ultrasound that Leandro Fernández, MD., is working on. It is called VOCAL Imaging (Virtual Organ Computer-Aided Analysis).

These images are related to this new technology:

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