acute renal failure with loin pain and patchy renal vasoconstriction

Acute Renal

Failure with Severe Loin Pain and Patchy Renal Vasoconstriction in a Patient without Hypouricemia, Provoked by Epileptic Seizure: (a) Contrast-enhanced computed tomography with 40 mL of iodine contrast agent performed during an episode of acute kidney injury. A nephrographic-phase image at 120 s after contrast administration shows patchy areas of hypoattenuation in both kidneys. (b) Computed tomography 24 h after contrast administration demonstrates persistent enhancement in the patchy areas, which correspond to the hypoattenuated areas on nephrographic-phase CT. The wedge-shaped areas comprise multiple linear bands of contrast enhancement. (c) Diffusion-weighted imaging shows signal hyperintensity in the hypoattenuated areas on contrast-enhanced computed tomography.

Acute renal

failure with loin pain and patchy renal vasoconstriction. Coronal (a, b) arterial-phase images showed normal, symmetric size and thickness of both kidneys, with multiple bilateral wedge-shaped nonenhancing parenchymal regions (thin arrows).

Acute renal

failure with loin pain and patchy renal vasoconstriction. Coronal (a, b) arterial-phase images showed normal, symmetric size and thickness of both kidneys, with multiple bilateral wedge-shaped nonenhancing parenchymal regions (thin arrows).

Acute renal

failure with loin pain and patchy renal vasoconstriction. Axial (c, d) images confirmed kidneys of normal size and thickness, with multiple bilateral wedge-shaped nonenhancing parenchymal regions (thin arrows) and normal overlying capsular contour.

Acute renal

failure with loin pain and patchy renal vasoconstriction. Axial (c, d) images confirmed kidneys of normal size and thickness, with multiple bilateral wedge-shaped nonenhancing parenchymal regions (thin arrows) and normal overlying capsular contour.

Acute renal

failure with loin pain and patchy renal vasoconstriction. CT-angiography maximum-intensity projection (MIP) reconstructions (e-g) showed uniformly thinner-than-usual right (arrows, 2mm) and left (thin arrows) renal arteries, compared to usual caliber for age and to the other splanchnic vessels.

Acute renal

failure with loin pain and patchy renal vasoconstriction. CT-angiography MIPP reconstructions (e-g) showed uniformly thinner-than-usual right (arrows, 2mm) and left (thin arrows) renal arteries compared to usual caliber for age and to the other splanchnic vessels, interpreted as consistent with vasoconstriction.

Acute renal

failure with loin pain and patchy renal vasoconstriction. CT-angiography MIPP reconstructions (e-g) showed uniformly thinner-than-usual right (arrows, 2mm) and left (thin arrows) renal arteries compared to usual caliber for age and to the other splanchnic vessels, interpreted as consistent with vasoconstriction.

Acute renal

failure with loin pain and patchy renal vasoconstriction. Coronal (a,b) and axial (c,d) nephrographic images confirmed persistence of multiple bilateral wedge-shaped nonenhancing parenchymal regions (thin arrows) in both kidneys.

Acute renal

failure with loin pain and patchy renal vasoconstriction. Coronal (a,b) and axial (c,d) nephrographic images confirmed persistence of multiple bilateral wedge-shaped nonenhancing parenchymal regions (thin arrows) in both kidneys.

Acute renal

failure with loin pain and patchy renal vasoconstriction. Coronal (a,b) and axial (c,d) nephrographic images confirmed persistence of multiple bilateral wedge-shaped nonenhancing parenchymal regions (thin arrows) in both kidneys.

Acute renal

failure with loin pain and patchy renal vasoconstriction. Coronal (a,b) and axial (c,d) nephrographic images confirmed persistence of multiple bilateral wedge-shaped nonenhancing parenchymal regions (thin arrows) in both kidneys.