acute renal arterial occlusion

Teilinfarkt
der linken Niere in der Computertomographie.
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Renal artery
occlusion (acute) • Complete devascularisation of transplant kidney - Ganzer Fall bei Radiopaedia
Botz B, Complete devascularisation of transplant kidney. Case study, Radiopaedia.org (Accessed on 23 Mar 2023) https://doi.org/10.53347/rID-68454 • CC by-nc-sa 3.0 (modified)
Renal
infarction: imaging findings on MDCT and CEUS.. Axial thick multiplanar reconstruction image showing lack of enhancement in the right kidney and lack of contrast filling in the right renal artery.
www.eurorad.org • CC by-nc-sa-4.0
Renal
infarction: imaging findings on MDCT and CEUS.. Coronal thick multi-planar reconstruction image showing the unenhanced part of the kidney and the renal artery thrombosis. Note the presence of a supernumerary right renal artery.
www.eurorad.org • CC by-nc-sa-4.0
Renal
infarction: imaging findings on MDCT and CEUS.. Coronal thick multi-planar reconstruction image showing the thrombosed right renal artery with the infarcted part of the kidney along with the normally opacified supernumerary artery and the respective normally enhanced renal parenchyma.
www.eurorad.org • CC by-nc-sa-4.0
Renal
infarction: imaging findings on MDCT and CEUS.. Curved multi-planar reconstruction image showing the right renal artery thrombosis.
www.eurorad.org • CC by-nc-sa-4.0
Renal
infarction: imaging findings on MDCT and CEUS.. Colour Doppler image showing lack of blood flow signals in the upper half of the renal cortex.
www.eurorad.org • CC by-nc-sa-4.0
Renal
infarction: imaging findings on MDCT and CEUS.. Immediately after the intravenous administration of 1.2 ml of microbubbles, the renal cortex appears uniformly anechoic.
www.eurorad.org • CC by-nc-sa-4.0
Renal
infarction: imaging findings on MDCT and CEUS.. CEUS image 32 seconds after the administration of microbubbles showing the arrival of microbubbles in the lower half of the renal cortex. No enhancement is seen in the infarcted upper half of the kidney (arrowheads).
www.eurorad.org • CC by-nc-sa-4.0
Renal
infarction: imaging findings on MDCT and CEUS.. CEUS image 45 seconds after the administration of microbubbles showing the lack of enhancement in the infarcted part of the renal cortex (arrowheads) along with the normal enhancement of the lower part of the kidney.
www.eurorad.org • CC by-nc-sa-4.0
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Renal artery occlusion can happen acutely due to in-situ thrombus, embolism, or dissection. Unless immediately treated, it can lead to renal infarction .

Epidemiology

The condition is more common in the elderly, however, it may be seen in a younger age group if they have risk factors (described below). 10% of the cases have bilateral involvement.

Clinical presentation

Acute pain in the ipsilateral flank, lower abdomen or back are the usual presenting symptoms.

Pathology

Risk factors

Radiographic features

Fluoroscopy - IVP
  • after contrast administration there may be faint opacification (or nonopacification) of the affected kidney (with 'rim nephrogram' sign)
  • the affected kidney may be normal or enlarged
CT
  • acutely swollen and edematous kidney with perinephric stranding
  • patchy enhancement or non-enhancing kidney +/- 'cortical rim sign'
  • wedge-shaped focal infarcts if a segmental artery occlusion
Angiography (CT/conventional)

CT angiography shows the hypodense thrombus within the lumen, with possible attenuation of distal branches.

Treatment and prognosis

Acute renal artery occlusion is an emergency and requires immediate intervention. Treatment modalities include anticoagulation and thrombolysis/thrombectomy with renal artery stenting.

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu akuter Verschluss Arteria renalis:
Niereninfarkt
 
Wikipedia • CC BY-SA 3.0
Fibromuskuläre
Dysplasie
Wikipedia • CC BY 2.0
Sichelzellenanämie
 
pediatricimaging.org • CC-by-nc-sa 4.0
thorakale
Aortendissektion
Wikipedia • CC BY-SA 4.0