Kamel I R, Berkowitz J F
Department of Radiology, New York Medical College, Westchester County Medical Center, Valhalla 10595, USA.
J Comput Assist Tomogr. 1996 Sep-Oct;20(5):803-6. doi: 10.1097/00004728-199609000-00023.
The cortical rim sign has frequently been described as a sign of renal infarction. It is reported to be present in approximately 50% of focal or global infarcts and is thought to be due to an intact renal collateral circulation. This study evaluates the incidence and temporal development of the cortical rim sign in posttraumatic renal vascular compromise.
This retrospective study included 20 patients who were diagnosed by contrast-enhanced CT to have posttraumatic focal or global infarcts. The CT scans were reviewed to evaluate the size of infarcts and the presence and appearance of the rim sign. Medical records were reviewed to identify the timing of trauma in relation to the CT examination.
Eight patients had multiple CT examinations and 12 had a single CT study. For all cases that demonstrated a rim sign (n = 14, 8 of which had more than one CT), the earliest appearance of the rim sing was 8 h (median time to appearance was 7 days). All cases with no rim sign (n = 6) were evaluated within 10 h of trauma, with a median time of 4 h.
This study suggests that in spite of the presence of renal collateral circulation, it takes a minimum period of 8 h after trauma for this circulation to expand and become apparent on CT. CT demonstrated a rim sign in all cases performed after 1 week.
皮质边缘征常被描述为肾梗死的征象。据报道，约50%的局灶性或整体性梗死中存在该征象，被认为是由于肾侧支循环完整所致。本研究评估创伤后肾血管损伤中皮质边缘征的发生率及时间演变。
本回顾性研究纳入20例经对比增强CT诊断为创伤后局灶性或整体性梗死的患者。对CT扫描图像进行分析，评估梗死灶大小以及边缘征的有无及表现。查阅病历以确定创伤时间与CT检查的关系。
8例患者接受了多次CT检查，12例患者仅进行了一次CT检查。在所有显示边缘征的病例中（n = 14，其中8例进行了不止一次CT检查），边缘征最早出现时间为8小时（出现的中位时间为7天）。所有无边缘征的病例（n = 6）均在创伤后10小时内进行评估，中位时间为4小时。
本研究表明，尽管存在肾侧支循环，但创伤后该循环至少需要8小时才能扩张并在CT上显影。CT显示在创伤1周后进行的所有检查中均出现边缘征。
