Computed tomography of renal infarction: clinical and experimental observations

Glazer, Gary M.; Francis, Isaac R.; Brady, Terry M.; Teng, Sangli

doi:10.2214/ajr.140.4.721

Cited by 56 publications

(27 citation statements)

References 0 publications

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“…Renal infarction is isodense on nonenhanced CT and becomes a wedge-shaped area of low attenuation after contrast enhancement (15). We have a similar case to reinforce this concept.…”

Section: Discussionsupporting

confidence: 68%

Evaluation of significance of clinical information and intravenous contrast administration for diagnostic accuracy during emergent abdominal computed tomographic examination

Yeung

Sheu

Chen

et al. 1997

Emergency Radiology

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The purpose of this study was to evaluate the need for clinical information and intravenous iodine contrast administration for disease diagnosis in patientslinical history is considered to improve the diagnostic rate of plain radiographs (1-3). Contrast-enhanced and nonenhanced computed tomographic (CT) studies are also important in the diagnosis of abdominal trauma (4, 5) and solid organ minors (6, 7). CT has been used as a good imaging modality to evaluate patients who present with acute abdominal pain from such conditions as appendicitis, diverticulitis, mechanical bowel loop obstrucuon, abdominal abscess, acute inflammatory lesions, bowel ischemia, liver abscess, acute pancreatitis, and abdominal trauma (8,9). Patients who present with an acute abdomen are frequently encountered in the emergency room. Emergent abdominal CT provides additional information for prompt diagnosis and management. Interventional or surgical decisions can be made quickly on the basis of the CT results (8). To our knowledge, a comparison study of the importance of clinical history and emergent CT with and without contrast enhancement has not 276 9 Diagnostic Accuracy in Abdominal CT Examination Emergency Radiology 9 September/October 1997 been described. This study was carried out to evaluate the influence of clinical history and nonenhanced and/or enhanced CT examinations on the diagnostic accuracy rate and to examine the possible controversial conditions. MATERIALS AND METHODSA prospective study of emergent abdominal CT examinations was randomly performed. One hundred fifty patients (85 males and 65 females; ages 2-98 years; mean age = 52.4 years) who presented with an acute abdomen were surveyed during a period of 3 consecutive months.The patients were scanned in a helical CT scanner (CT ProSpeed; General Electric Medical Systems, Milwaukee, WI). Nonenhanced and enhanced CT were both obtained for the same region of interest and using the same slice thickness of 10 mm and slice interval of ]0 n~n throughout the abdomen and pelvis. Oral contrast medium was not routinely used in our emergent abdominal CT study. Enhanced CT was obtained with an intravenous infusion of ]00 ml of contrast medium (meglumine iothalamate USR 60%). The nonenhanced and enhanced CT images of the same study were recorded on separate CT films so that the radiologists studying the nonenhanced images would obtain no information from the enhanced study.All diagnostic interpretations were provided sequentially in three phases: (1) nonenhanced CT studies with no available clinical history, (2) nonenhanced CT studies with clinical history provided, and (3) combined nonenhanced and enhanced CT studies with available clinical information. A total of 450 CT studies were thus evaluated. Three radiology specialists (G-C. L., K-W. Y., and Y-T. K.) participated in the research. At first, they interpreted the nonenhanced CT films with no available clinical information. Second, with clinical information provided, they studied the nonenhanced CT images again, but they were not ...

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“…Renal infarction is isodense on nonenhanced CT and becomes a wedge-shaped area of low attenuation after contrast enhancement (15). We have a similar case to reinforce this concept.…”

Section: Discussionsupporting

confidence: 68%

Evaluation of significance of clinical information and intravenous contrast administration for diagnostic accuracy during emergent abdominal computed tomographic examination

Yeung

Sheu

Chen

et al. 1997

Emergency Radiology

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“…Renal infarct in segmental form is generally repre sented by a wedge-shaped area of low attenuation sur rounded by a high-attenuation subcapsular rim on con trast CT [1,2], On the other hand, wedge-shaped high-attenuation areas seen several hours after injection of con trast medium have been proposed as characteristic of patchy vasoconstriction [3. 4).…”

Section: Discussionmentioning

confidence: 99%

“…CT is also useful in the specific diagnosis of renal infarction because of its characteristic findings of wedge-shaped low density areas [1,2]. However, it still remains unclear whether such CT findings always represent renal infarc tion.…”

Section: Introductionmentioning

confidence: 99%

Persistent Wedge-Shaped Low-Density Lesions on Computed Tomography of the Kidneys without Infarction

Sakemi

Kudo²,

Nagano³

et al. 1989

Nephron

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A patient with acute lymphoblastic leukemia, who developed acute renal failure, was imaged by computed tomography (CT). Persistent wedge-shaped areas of low attenuation in the kidneys were shown by sequential scans but no areas of infarction were found at autopsy. This case suggests that a wedge-shaped low-density lesion on CT may occur not only in infarcted areas, but also in areas where patchy vasoconstriction occurs.

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“…The patient improved clinically and was discharged 1 6 days after admission. sion of subcapsular cortex from collateral vessels, although alternative mechanisms are also possible [8,9]. All of our patients had well circumscribed areas of low attenuation on contrast-enhanced scans; in addition, most extended to the periphery of the liver and were wedge-shaped (four of five patients).…”

Section: Casementioning

confidence: 59%