Column of bertin: Normal sonographic findings

Abstract

Introduction: We aimed to describe the normal and pathologic sonographic (US) findings of column of Bertin (CB). Materials and methods: The study was performed on sixty-six patients who had CB on CT. CB was found to be suspicious in 22 cases; with either hypoechoic, heterogeneous, bulging contour, increased vascularity or cystic areas on US. Patient underwent US and CT imaging following their initial CT and US examinations, respectively. On CT images, isodens and homogeneous texture, enhancement equal to renal cortex were accepted as normal findings. The thickness of CB on axial (AT) and longitudinal (LT) sonography images and the thickness of renal parenchyme (PT) on longitudinal images were measured. The ratio of AT to PT and LT to PT were calculated. Echogenity, vascularity, and contours of CB were evaluated on sonography. The data evaluated with Pearson and t tests. Results: CB was bilateral in 39, and double in 9 cases. Totally 136 CB were evaluated. In two sonographically suspicious CB, renal cell carcinoma (pathologically confirmed) and Bosniak type 2 cysts were detected. In LT, AT, LT/PT and AT/PT were 14.0+3.1 mm (maximum: 23.4mm), 13.2±2.9 mm (maximum: 21.8 mm), 1.1±0.19 (maximum: 1.56) and 1.0±0.17 (maximum: 1.67) in normal cases, 28 mm, 26 mm, 2.15 and 2 mm, in case with renal cell carcinoma. The correlation between thickness of CB and parenchyme was significant (AT-PT r=0.555, p<0.001, and LT-PT r=0.614, p<0.001). Peripheral vascularities were observed in all, central minute vascular focuses in 24 (18%), hypoechogenity in 12 (9.0%), bulging exterior contour in 9 (6%) CB. Conclusion: Increased vascularity, hypoechogenity, increased thickness of CB and thickness to parenchyme ratio are suspicious sonographic findings which may necessitate CT examination.