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

Brian L. Dunfee1,2, Brian C. Lucey3 and Jorge A. Soto4

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.


Figure 1
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  		Fig. 1 —Diagram shows study population.

 

Figure 2
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  		Fig. 2A —30-year-old man with grade I right renal injury after motor vehicle accident. Small right subcapsular hematoma (arrow) is present without evidence of underlying cortical injury; note contrast-mixing artifact is present within inferior vena cava.

 

Figure 3
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  		Fig. 2B —30-year-old man with grade I right renal injury after motor vehicle accident. Follow-up image obtained 5 weeks after A reveals only minimal regional perirenal fat stranding.

 

Figure 4
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  		Fig. 3A —32-year-old woman with grade II left renal injury after fall from second-story balcony. Small (< 1 cm) cortical laceration (arrow) is present with large perirenal hematoma.

 

Figure 5
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  		Fig. 3B —32-year-old woman with grade II left renal injury after fall from second-story balcony. Follow-up CT image obtained 8 weeks after A reveals absence of parenchyma scarring with minimal surrounding perinephric stranding.

 

Figure 6
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  		Fig. 4A —52-year-old man with grade III left renal injury after stab wound to left flank. Wide left renal laceration (arrow) is present with small surrounding hematoma.

 

Figure 7
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  		Fig. 4B —52-year-old man with grade III left renal injury after stab wound to left flank. Twenty weeks after trauma, CT image reveals cortical thinning and retraction in region of previous laceration (arrow).

 

Figure 8
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  		Fig. 5A —43-year-old man with grade IV left renal injury after being struck by car while walking. Wedge-shaped perfusion defect (arrow) is present in interpolar region of left kidney with surrounding hematoma.

 

Figure 9
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  		Fig. 5B —43-year-old man with grade IV left renal injury after being struck by car while walking. Follow-up CT image obtained 12 weeks after A shows cortical thinning and retraction in same region (arrow).

 

Figure 10
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  		Fig. 6A —34-year-old woman with grade V left renal injury after rollover motor vehicle accident. Initial image reveals filling defect in left main renal artery (arrow) with complete absence of renal enhancement.

 

Figure 11
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  		Fig. 6B —34-year-old woman with grade V left renal injury after rollover motor vehicle accident. Five weeks after injury, image shows significant atrophy of left kidney.

 

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