HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Dunfee, B. L. Articles by Soto, J. A. PubMed PubMed Citation Articles by Dunfee, B. L. Articles by Soto, J. A. Social Bookmarking                      What's this?

Development of Renal Scars on CT After Abdominal Trauma: Does Grade of Injury Matter?

¹ Department of Radiology, Division of Body Imaging, Boston University Medical Center, Boston, MA.
² Present address: Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, 251 E Huron St., Feinberg 4-710Y, Chicago, IL 60611.
³ Chief Radiology Service, Boston VA Healthcare System, Boston University School of Medicine, Boston, MA.
⁴ Department of Radiology, Division of Body Imaging, Boston University Medical Center, Boston, MA.

OBJECTIVE. The objective of our study was to determine whether there is an association between the grade of a traumatic renal injury and the subsequent development of renal parenchymal scars on CT.

MATERIALS AND METHODS. We performed a retrospective study encompassing all acute trauma patients admitted to our institution over a 42-month period found to have renal parenchyma injuries on initial MDCT and also to have undergone a follow-up CT performed at least 1 month after trauma. We identified 54 patients who sustained blunt (n = 44) or penetrating (n = 10) abdominal trauma. The renal injuries were graded by two radiologists according to the Organ Injury Scaling Committee of the American Association for the Surgery of Trauma (AAST), grades I through V. Follow-up CT was reviewed for the presence of parenchymal distortion, scarring, or perfusion defects.

RESULTS. Of the 54 patients, 12 had grade I injury, eight had grade II injury, 22 had grade III injury, 10 had grade IV injury, and two had grade V injury. Grades I and II traumatic renal injuries were undetectable on follow-up CT. Grade III injuries resulted in the development of renal scars in 14 of 22 (64%) patients. Scarring resulted in all patients with grades IV and V injuries.

CONCLUSION. Grades I and II renal injuries heal completely, whereas higher grades of renal trauma result in permanent parenchymal scarring. Hence, incidentally discovered renal scars in patients with a history of minor renal trauma should be attributed tentatively to other causes that may or may not require additional investigation.

Keywords: AAST injury scale • emergency radiology • renal function • renal injuries • renal scarring • trauma

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?