Nuñez D, Becerra J L, Fuentes D, Pagson S
Department of Radiology, University of Miami School of Medicine, FL 33101, USA.
AJR Am J Roentgenol. 1996 Sep;167(3):777-80. doi: 10.2214/ajr.167.3.8751699.
Eight patients with traumatic occlusion of the renal artery were retrospectively reviewed to assess the diagnostic contribution of helical CT and to determine whether the information it provides can replace angiographic data in patient evaluations.
We reviewed the medical records and imaging studies of eight patients with renal artery occlusion caused by blunt abdominal trauma. All patients were scanned using a helical protocol that included an 8-mm collimation with a 1:1 pitch and a monophasic IV injection of iodinated contrast material. The timing of the imaging studies, the type of surgical treatment, and the patient outcome were tabulated. Evaluated data included the location of the occlusion as depicted by helical CT and angiography, whether a CT nephrogram was obtained, the presence of a peripheral rim effect, and the nature of associated injuries.
Helical CT revealed occlusion of a main renal artery in seven patients and obstruction of a main branch in one patient. In all cases the occlusion occurred within the proximal 2 cm of the renal artery. In five patients, the findings were depicted equally well by helical CT and angiography. In two patients, the helical CT findings were confirmed by surgery and autopsy, respectively. Significant associated injuries were revealed in seven patients. The CT nephrogram was absent in seven patients and partially present in one patient. The peripheral rim effect was seen in six patients.
Basic contrast-enhanced helical CT can reliably reveal traumatic occlusion of the renal artery and depict the level of obstruction.
回顾性分析8例创伤性肾动脉闭塞患者，以评估螺旋CT的诊断价值，并确定其提供的信息在患者评估中是否可替代血管造影数据。
我们回顾了8例因腹部钝性创伤导致肾动脉闭塞患者的病历和影像学检查。所有患者均采用螺旋扫描方案，包括8mm准直、1:1螺距以及静脉单相注射碘化造影剂。将影像学检查的时间、手术治疗类型和患者预后制成表格。评估的数据包括螺旋CT和血管造影显示的闭塞部位、是否获得CT肾图、是否存在外周边缘效应以及相关损伤的性质。
螺旋CT显示7例患者主肾动脉闭塞，1例患者主分支阻塞。所有病例中，闭塞均发生在肾动脉近端2cm内。5例患者中，螺旋CT和血管造影对结果的显示同样良好。2例患者中，螺旋CT结果分别经手术和尸检证实。7例患者发现有明显的相关损伤。7例患者未获得CT肾图，1例患者部分获得。6例患者可见外周边缘效应。
基础对比增强螺旋CT能够可靠地显示创伤性肾动脉闭塞并描绘阻塞水平。
