Multi-detector CT assessment of traumatic renal lesions

Abstract

Background: Urinary tract injuries occur in 3–10% of abdominal trauma, kidneys being the most commonly injured. Contrast-enhanced CT is the imaging technique  of choice for renal trauma, since it can quickly and accurately demonstrate not only renal injuries, and also associated damage to other organs. CT can help detect active hemorrhage and urine leakage and is the most accurate screening test for high-grade injuries and is of great help in guiding transcatheter embolization and delineating preexisting disease entities.

Aim of the work: To demonstrate different traumatic lesions of the kidneys using multi-detector CT, and its use in staging and management of lesions.

Methods: Study was carried out on 41 patients with abdominal trauma and suspected renal injury. All patients were subjected to contrast-enhanced multiphasic renal CT study in correlation with surgical and conventional angiography data when available.

Results: All patients were classified after the American Association for the Surgery of Trauma grading system. Grade I injury was diagnosed in 2.4% of patients, grade II in 7.3%, grade III in 29.3%, grade IV in 53.7% and grade V in 7.3%. 80.5% of patients were managed conservatively, 12.2% of patients underwent total  nephrectomy and 7.3% of patients died before management.

Conclusion: Multiphasic CT well demonstrated various traumatic renal lesions with proper diagnosis and staging of renal trauma and guiding management

Keywords: Kidneys; Computed tomography; Trauma; Pseudoaneurysm; Fistula; Grading