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The two most common sonographic abnormalities in the kidneys of 23 tuberous sclerosis (TS) patients ranging in age from newborn to 30 years are angiomyolipomas (12/23) (AML) and renal cysts (10/23). These usually both occur in the same patient with only 9 cases (39%) having sonographically normal kidneys. Of the 14 affected patients, 2 had cysts without AML and 4 others had AML without cysts. The sonographic appearance of an AML varied from a large 6 cm solid mass with little increased echogenicity (1/12) to subtle small (4 mm) extremely echogenic regions in the periphery of the kidney (11/12). The sonographic appearance of the cysts were anechoic lesions varying in size from 2 mm to 2 cm with thin uniform posterior walls and posterior enhancement. Renal lesions are found more frequently with increasing age. Sonography is the preferred screening procedure for the renal lesions of T.S.
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