The CT nephrogram: implications for evaluation of urinary tract disease.

Saunders, H. Stuart; Dyer, Raymond B.; Shifrin, Roger Y.; Scharling, Eric S.; Bechtold, Robert E.; Zagoria, Ronald J.

doi:10.1148/radiographics.15.5.7501851

Cited by 87 publications

(42 citation statements)

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“…Some studies showed that CT depicts areas of underperfusion in cases with major arterial interruption, and the size of the territory with no contrast medium enhancement directly correlates with the size of the obstructed feeding vessel and reflects the volume of renal parenchyma supplied [5][6][7]. D'Souza et al [8] developed a method of measuring residual parenchymal volume in abnormal kidneys using a calibrated CT image processing method.…”

Section: Discussionmentioning

confidence: 99%

Spiral CT During Selective Accessory Renal Artery Angiography: Assessment of Vascular Territory Before Aortic Stent-Grafting

Dorffner

Thurnher

Prokesch

et al. 1998

Cardiovasc Intervent Radiol

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We evaluated the vascular territory of accessory renal arteries in cases where the vessel might be overlapped by an aortic stent-graft. Spiral CT during selective accessory renal artery angiography was performed in four patients with abdominal aortic aneurysms (including one with a horseshoe kidney). The volume of the vascular territory of each renal artery was measured using a software program provided by the CT unit manufacturer. The supernumerary renal arteries perfused 32%, 37%, 15%, and 16% of the total renal mass, respectively. In two patients, stent-grafts were implanted, which resulted in occlusion of the supernumerary renal artery. The volume of the renal infarction was equal to the volume perfused by the artery as calculated before implantation of the stent-graft. The method proposed is accurate for estimating the size of the expected renal infarction. It might help to determine whether placement of a stent-graft is acceptable.

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Section: Discussionmentioning

confidence: 99%

Spiral CT During Selective Accessory Renal Artery Angiography: Assessment of Vascular Territory Before Aortic Stent-Grafting

Dorffner

Thurnher

Prokesch

et al. 1998

Cardiovasc Intervent Radiol

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“…This appearance is ascribed to the decreased flow of contrast due to stasis and eventual hyperconcentration in the infected tubules [3] . Striated nephrogram is not specific and is also seen in some other conditions like renal vein thrombosis, ureteric obstruction and contusion [4] . Pyelonephritis may manifest as wedge shaped zones of decreased attenuation or a hypodense mass in its focal form (Figure 3).…”

Section: Acute Pyelonephritismentioning

confidence: 99%

Multimodality imaging of renal inflammatory lesions

Das

Ahmad

Sharma

et al. 2014

WJR

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Spectrum of acute renal infections includes acute pyelonephritis, renal and perirenal abscesses, pyonephrosis, emphysematous pyelonephritis and emphysematous cystitis. The chronic renal infections that we routinely encounter encompass chronic pyelonephritis, xanthogranulomatous pyelonephritis, and eosinophilic cystitis. Patients with diabetes, malignancy and leukaemia are frequently immunocompromised and more prone to fungal infections viz . angioinvasive aspergillus, candida and mucor. Tuberculosis and parasitic infestation of the kidney is common in tropical countries. Imaging is not routinely indicated in uncomplicated renal infections as clinical findings and laboratory data are generally sufficient for making a diagnosis. However, imaging plays a crucial role under specific situations like immunocompromised patients, treatment non-responders, equivocal clinical diagnosis, congenital anomaly evaluation, transplant imaging and for evaluating extent of disease. We aim to review in this article the varied imaging spectrum of renal inflammatory lesions. Multimodality imaging of renal inflammatory lesionsCore tip: Imaging in renal infections is challenging, given the relatively non-specific nature of findings in majority of the cases. A careful assessment of clinical situation in question is essential to accurately choose the imaging modality which would provide most information. In this review we discuss the appropriateness of specific imaging modalities, to allow the radiologist to choose the best modality for a given clinical situation. In addition, some entities such as acute pyelonephritis, Xanthogranulomatous pyelonephritis and emphysematous pyelonephritis have some specific imaging features. In this review we describe and illustrate such specific features, to facilitate their recognition when present.

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“…8 occlusion or renal pedicle injury, contrast CT has been shown to be very reliable in making this diagnosis. 19,20 Vascular injuries to the kidney may be difficult to diagnose with ultrasonography unless duplex scanning or color or power Doppler imaging is used. However, duplex imaging probably will not be useful in the acute trauma setting because of the time needed to perform an adequate study.…”

Section: Discussionmentioning

confidence: 99%

Use of ultrasonography in the patient with acute renal trauma.

McGahan

Richards

Jones

et al. 1999

Journal of Ultrasound in Medicine

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The purpose of this study was to assess the use of emergent ultrasonographic examination in acute traumatic renal injuries. Over a 3 year period, prospective data of all patients who had an emergency ultrasonogram were recorded. Thirty‐two patients with 37 renal injuries were studied retrospectively to identify in how many patients the sonogram detected free fluid or a renal parenchymal abnormality. Free fluid in the abdomen was identified in 19 of 32 patients (59%). However, 12 of these 19 patients had concomitant injury, such as splenic rupture requiring splenectomy, severe liver lacerations, or bowel lacerations requiring repair, that were possible causes of the free fluid. Eliminating these patients, only seven of 20 patients with isolated renal injuries had free fluid in the abdomen (35%), whereas 13 of 20 patients (65%) had no evidence of free fluid. All seven patients with free fluid had moderate or severe renal injuries. Renal parenchymal abnormalities were identified on ultrasonograms in eight of 37 (22%) of injured kidneys. The abnormalities were detected more commonly in cases of severe injury (60%). In conclusion, acute injuries of the kidney from blunt abdominal trauma often are associated with significant splenic, hepatic, or bowel trauma. Isolated renal injuries frequently occur without the presence of free fluid in the abdomen. Furthermore, the ultrasonogram of the kidney often is normal with acute renal injuries, but it is more likely to be abnormal with severe (grade II or greater) renal injuries. Sonography may be used in the triage of patients with blunt abdominal trauma and possible renal injury. However, a negative ultrasonogram does not exclude renal injury, and, depending on clinical and laboratory findings, other imaging procedures such as computed tomography should be performed.

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The CT nephrogram: implications for evaluation of urinary tract disease.

Cited by 87 publications

References 0 publications

Spiral CT During Selective Accessory Renal Artery Angiography: Assessment of Vascular Territory Before Aortic Stent-Grafting

Spiral CT During Selective Accessory Renal Artery Angiography: Assessment of Vascular Territory Before Aortic Stent-Grafting

Multimodality imaging of renal inflammatory lesions

Use of ultrasonography in the patient with acute renal trauma.

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