Home of Radiologists


Recent Topics

جاري التحميل ...

Column of Bertin , kidney

• known as Hypertrophic or enlarged column of Bertin, junctional parenchyma, lobar dysmorphism, renal pseudotumor, renal septum, septal cortex, focal cortical hyperplasia, benign cortical rest

• Hypertrophic band of normal cortical tissue that separates pyramids of renal medulla

○ At junction of upper and middle 1/3 of kidney
○ Left side > right side
○ Unilateral > bilateral (18% of cases)

○ Less than 3 cm

                                                       Ultrasonographic Findings
• Grayscale ultrasound
○ Homogenous round lesion isoechoic to renal cortex
○ Extends between renal pyramids
○ Normal renal contour
○ Bordered by echogenic junctional parenchymal line and echogenic triangular junctional parenchymal defect
○ Indentation of renal sinus laterally
○ Echogenicity may be increased because of anisotropy

• Color Doppler
○ Normal perfusion indicating normal renal tissue
○ No vascular distortion with preserved arcuate arteries surrounding pyramids
○ No abnormal vessels

• Contrast-enhanced ultrasound
○ Enhancement of column of Bertin is identical to normal renal cortex on all phases

CT Findings
○ Similar enhancement as normal renal cortex on corticomedullary and excretory phases

MR Findings
• Similar signal intensity to renal cortex on T1WI, T2WI, and contrast-enhanced sequences

• Embryology: Incomplete resorption of polar parenchyma of subkidneys that fuse to form normal kidney
○ Normal renal development: Superior and inferior subkidneys corresponding to upper and lower calyces fuse, with upper pole of inferior subkidney overlapping lower pole of superior subkidney

○ Asymptomatic, normal variant

○ Usually found incidentally on imaging
○ Most likely to simulate mass on sonography
○ Optimize ultrasound by focusing on lesion and placing it in center of FOV

• Normal variant, but can mimic solid tumor Image Interpretation Pearls
• Isoechoic to, and continuous with, renal cortex
• Normal perfusion, no vascular distortion
• No mass on CECT or T1WI C+
• In duplication, bridging parenchyma separates collecting systems; in column of Bertin, there is no bridging

Imaging gallery 

hypertrophied column of Bertin indenting the sinus fat in the mid kidney. Note its isoechogenicity relative to the cortex and the smooth external contour .

  hypertrophied column of Bertin  which is isoechoic to renal cortex .

Enhanced MR of the previous patient (performed for another renal lesion, not shown) shows that the lesion  has the same signal intensity as the renal cortex , compatible with a hypertrophied column of Bertin.

عن الكاتب


اتصل بنا

جميع الحقوق محفوظة