Kontrastlı çok dedektörlü bilgisayarlı tomografi ile akut spontan izole renal arter diseksiyonunun saptanması

Abstract

Spontaneous isolated renal artery dissection is a very rare but threatening condition that can be difficult to diagnose early due to nonspecific symptoms. The goal of this study is to evaluate the incidence and multidetector computed tomography (MDCT) findings of this rare and important condition. Materials and methods: We retrospectively examined the images of all patients who underwent contrast enhanced abdominal MDCT scans due to various abdominal complaints between July 2017-July 2020. 14000 contrast enhanced MDCT scans were evaluated. Only the isolated renal artery dissections without aortic involvement were included. Age, gender, symptoms, presence of thrombosis or renal parenchymal ischemiainfarct were noted. Average extension of dissection and distance from origin were measured. Results: 8 (0.054%) patients had spontaneous isolated renal artery dissection (5M, 3F, age range 43-61 years). The mean distance from origin was 3.7 cm and the average extension was 3.8 cm. 3 patients had kidney infarct with a focal area of decreased perfusion. Only 1 patient underwent digital subtraction angiography. Patients were started on an anticoagulation therapy. No surgical or interventional therapy was deemed necessary. Dissections completely disappeared in patients who could undergo follow-up MDCT. Conclusion: Spontaneous isolated renal artery dissection is a very rare condition. The etiology is not well known. The initial symptoms are generally nonspecific such as severe upper abdomen or flank pain. There are several treatment options available such as medical, surgical or interventional managements. Early diagnose is important to prevent complications. It should be considered in patients with new-onset flank or abdominal pain.