Abdominal and Renal Ultrasound

What it does

Abdominal and Renal Ultrasound reads complete and limited abdominal studies: right upper quadrant, renal, aortic and right-lower-quadrant scans, in adults and children. The run recognises which kind of study was uploaded and which standard plane each image shows, so a renal-colic scan and a full abdomen both come back organised by organ.

The result goes organ by organ. The liver gets a steatosis grade with the hepatorenal index and a focal-lesion list with a surveillance category; the gallbladder gets stones, sludge, wall, pericholecystic fluid, polyps and the common bile duct; the kidneys get hydronephrosis grade, length, cortex, cysts and stones; the spleen and aorta are measured. For children, the paediatric acute-abdomen questions are answered: appendicitis, intussusception and pyloric stenosis.

Intended use

Decision support for the physician who performs or reads abdominal ultrasound: right-upper-quadrant pain, abnormal liver tests, renal colic or acute kidney injury, HCC surveillance, AAA screening and the child with abdominal pain. Organ measurements depend on the plane, and adult and paediatric norms differ, so each value names its image and reference.

Who it is for

Radiologists and radiology residents, internists, gastroenterologists and hepatologists, nephrologists and urologists, emergency physicians and paediatric radiologists. Developers add the run to reporting systems, liver surveillance programmes and AAA screening workflows.

Accepted input

• Stills and cine: DICOM Ultrasound Image and Multi-frame objects, grey-scale and colour Doppler.
• Complete or limited studies: a full abdomen, or a focused RUQ, renal, aortic or right-lower-quadrant scan; the study type is detected, not declared.
• Graded-compression clips: right-lower-quadrant cine for the appendix.

Requirements

Requirement	Why
SequenceOfUltrasoundRegions calibration	Kidney length, CBD and aortic diameters, polyp and pylorus sizes in millimetres
Liver and right kidney in one image	The hepatorenal index compares their echogenicity
Transverse and longitudinal aorta	The maximum outer-to-outer diameter is taken across both
Spleen long-axis image	Spleen length
Compression cine of the right lower quadrant	Appendix compressibility cannot be judged on a still

Bowel gas and body habitus limit views; organs not seen are listed with the reason rather than reported as normal.

Optional context

Age (adult or paediatric norms), sex, the clinical question and risk context such as cirrhosis under HCC surveillance go in clinical_context.

The result

One JSON result in sections, ordered by organ, with findings, measurements and classifications. Organ masks are returned as DICOM SEG and focal lesions keep a lesion_id and liver location.

Section	Content
Organ segmentation	Standard-plane label per image; liver, gallbladder, kidney (capsule, cortex, medulla, central echo complex) and spleen masks
Liver steatosis	Steatosis grade (none, mild, moderate, severe) and hepatorenal index
Focal liver lesions	Lesion detection, cystic or solid, size and LI-RADS US surveillance category
Gallbladder and bile duct	Stones, sludge, wall thickness, pericholecystic fluid, distension, polyps with size, CBD diameter and a gallbladder-cancer flag
Hydronephrosis	Grade (none, mild, moderate, severe) and side
Kidneys	Length, cortical thickness and echogenicity, simple or complex cysts, stones
Spleen size	Length and a splenomegaly flag
Abdominal aorta	Maximum outer-to-outer diameter, AAA flag and mural thrombus
Appendicitis	Appendix seen or not, diameter, compressibility, periappendiceal fat or fluid, appendicolith
Intussusception	Target or pseudokidney sign, ileocolic or small-bowel type, length
Pyloric stenosis	Pyloric muscle thickness, channel length and gastric outlet passage
Draft report	Opt-in (options.report): an English narrative that interprets the result for the reader (findings, impression, limitations); every number is checked against the findings

Standards

• Liver: ACR LI-RADS US Surveillance v2024 for lesions found on surveillance scans.
• Gallbladder: Tokyo Guidelines 2018 for acute cholecystitis signs; SRU 2022 consensus on gallbladder polyps.
• Kidneys: SFU hydronephrosis grading; UTD 2014 urinary-tract dilation classification for children.
• Aorta: SVS 2018 abdominal aortic aneurysm guideline.
• DICOM: SR Measurement Report TID 1500; SEG for organ and lesion masks; GSPS calipers; Encapsulated PDF.

Guidance notes

Gallbladder findings are grouped as the Tokyo 2018 local signs of acute cholecystitis: wall thickening, distension, stones or debris and pericholecystic fluid. The sonographic Murphy sign is a bedside finding that still images do not show. Polyps are placed in the SRU 2022 risk categories from their size and shape. An abdominal aortic diameter of 3.0 cm or more is flagged as an aneurysm, as defined in the SVS 2018 guideline.

Related models

• us/fast reads trauma windows for free fluid.
• us/scrotal adds testicular torsion to the paediatric acute-abdomen work-up.