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General Comments:

Because an untrained or inexperienced person could misinterpret the image, we feel it is extremely important to use an experienced board certified veterinary radiologist, or a properly trained and experienced board certified veterinary internist to test for PKD.  At a minimum, we suggest  a properly trained sonographer, experienced with feline kidneys, videotaping the testing, with interpretation and diagnosis by a board certified veterinary radiologist.

Normal Kidney Showing Medulla

Comments from Dr. Shiroma:

"The other dark areas within the kidneys (that do not represent cysts) toward the central and hilar regions represent the medulla. In real time scanning, the echogenicity of the cysts and shape of the cysts can be differentiated from the medulla.  In some of the examples, the difference in echogenicity of the cysts and medulla is not readily apparent. ... Cysts in the cortex are readily identified. Cysts within the medulla are more difficult to define and can be missed by inexperienced sonographers (false negative). Small vessels at the junction of the cortex and medulla (accurate arteries) can be mistaken for small cysts (false positive). I didn't seen any examples that you could use to show accurate arteries. I'll keep this in mind and if I find a good example, I'll forward it to you. I also think its important to note that some cysts are irregular in shape and are not perfectly spherical as some may assume."

Jonathan T. Shiroma, DVM, Diplomat, American College of Veterinary Radiologists