TRAUMATIC OCCLUSION OF THE RENAL-ARTERY - HELICAL CT DIAGNOSIS

OBJECTIVE. Eight patients with traumatic occlusion of the renal artery were retrospectively reviewed to assess the diagnostic contribution o f helical CT and to determine whether the information it provides can replace angiographic data in patient evaluations. MATERIALS AND METHOD S. We reviewed the medical records and imaging studies of eight patien ts with renal artery occlusion caused by blunt abdominal trauma. All p atients were scanned using a helical protocol that included an 8-mm co llimation with a 1:1 pitch and a monophasic IV injection of iodinated contrast material. The timing of the imaging studies, the type of surg ical treatment, and the patient outcome were tabulated. Evaluated data included the location of the occlusion as depicted by helical CT and angiography, whether a CT nephrogram was obtained, the presence of a p eripheral rim effect, and the nature of associated injuries. RESULTS. Helical CT revealed occlusion of a main renal artery in seven patients and obstruction of a main branch in one patient. In all cases the occ lusion occurred within the proximal 2 cm of the renal artery. In five patients, the findings were depicted equally well by helical CT and an giography. In two patients, the helical CT findings were confirmed by surgery and autopsy, respectively. Significant associated injuries wer e revealed in seven patients. The CT nephrogram was absent in seven pa tients and partially present in one patient. The peripheral rim effect was seen in six patients. CONCLUSION. Basic contrast-enhanced helical CT can reliably reveal traumatic occlusion of the renal artery and de pict the level of obstruction.