CT evaluation of renovascular disease

Akira Kawashima, Carl M. Sandler, Randy D. Ernst, Eric P. Tamm, Stanford M. Goldman, Elliot K Fishman

Research output: Contribution to journalArticle

Abstract

Computed tomography (CT) plays an important role in evaluation and management of primary renovascular disease. Nonenhanced CT is useful for demonstrating renal hemorrhage, renal parenchymal or vascular calcifications, and masses. Contrast material-enhanced CT is essential to identify global or regional nephrographic abnormalities resulting from the vascular process (eg, renal infarcts, ischemia secondary to renal artery stenosis, arteriovenous communications). In addition, renal manifestations of a systemic disease (eg, vasculitis, thromboembolic disease) can be seen at CT. In trauma, occlusion of the main renal artery can be accurately diagnosed with contrast-enhanced CT. In cases of spontaneous renal hemorrhage without an apparent cause (eg, vasculitis, coagulopathy), a careful CT study should be performed to exclude renal cell carcinoma. The presence of fat in a hemorrhagic renal mass larger than 4 cm in diameter is characteristic of angiomyolipoma complicated by hemorrhage. Acute renal vein thrombosis appears as a clot in a distended renal vein, whereas renal vein retraction with collateral vessels is highly indicative of chronic thrombosis. Helical CT, especially with multiplanar two-dimensional and three-dimensional reconstruction following an intravenous injection of iodinated contrast material, has greatly improved our ability to directly image the proximal renal arteries and detect vascular lesions.

Original languageEnglish (US)
Pages (from-to)1321-1340
Number of pages20
JournalRadiographics : a review publication of the Radiological Society of North America, Inc
Volume20
Issue number5
StatePublished - Sep 2000

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Tomography
Kidney
Renal Veins
Renal Artery
Hemorrhage
Vasculitis
Contrast Media
Blood Vessels
Thrombosis
Vascular Calcification
Angiomyolipoma
Renal Artery Obstruction
Spiral Computed Tomography
Renal Cell Carcinoma
Intravenous Injections
Ischemia
Fats
Wounds and Injuries

Keywords

  • Aneurysm, renal, 81.73, 96.73
  • Arteriovenous malformations, renal, 81.1494, 96.149
  • Fistula, arteriovenous, 81.494, 96.494
  • Kidney, hemorrhage, 81.367, 96.367
  • Kidney, infarction, 81.77, 96.771
  • Kidney, injuries, 81.48, 96.41

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Kawashima, A., Sandler, C. M., Ernst, R. D., Tamm, E. P., Goldman, S. M., & Fishman, E. K. (2000). CT evaluation of renovascular disease. Radiographics : a review publication of the Radiological Society of North America, Inc, 20(5), 1321-1340.

CT evaluation of renovascular disease. / Kawashima, Akira; Sandler, Carl M.; Ernst, Randy D.; Tamm, Eric P.; Goldman, Stanford M.; Fishman, Elliot K.

In: Radiographics : a review publication of the Radiological Society of North America, Inc, Vol. 20, No. 5, 09.2000, p. 1321-1340.

Research output: Contribution to journalArticle

Kawashima, A, Sandler, CM, Ernst, RD, Tamm, EP, Goldman, SM & Fishman, EK 2000, 'CT evaluation of renovascular disease', Radiographics : a review publication of the Radiological Society of North America, Inc, vol. 20, no. 5, pp. 1321-1340.
Kawashima, Akira ; Sandler, Carl M. ; Ernst, Randy D. ; Tamm, Eric P. ; Goldman, Stanford M. ; Fishman, Elliot K. / CT evaluation of renovascular disease. In: Radiographics : a review publication of the Radiological Society of North America, Inc. 2000 ; Vol. 20, No. 5. pp. 1321-1340.
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