RadioGraphics, Vol 15, 1069-1085, Copyright © 1995 by Radiological Society of North America

ARTICLES

The CT nephrogram: implications for evaluation of urinary tract disease

HS Saunders, RB Dyer, RY Shifrin, ES Scharling, RE Bechtold and RJ Zagoria
Department of Radiology, Bowman Gray School of Medicine, Winston-Salem, NC 27157-1088, USA.

The urographic nephrogram is an important indicator of underlying functional and structural renal disease. With expansions in use of cross-sectional imaging, the computed tomographic (CT) nephrogram (ie, contrast material enhancement within the renal parenchyma) has assumed a greater role in the evaluation of urinary tract disorders. Both quantitative and qualitative nephrographic abnormalities are well demonstrated by CT, including global or segmental absence or persistence of the nephrogram, slowed temporal progression, striated pattern, and rim pattern. Global absence is nearly always unilateral and is most often seen with blunt abdominal trauma with renal pedicle injury. Segmental absence is attributable to focal renal infarction, most likely due to arterial emboli. Global persistence, which is much more common than segmental persistence, may be unilateral (caused by renal artery stenosis, renal vein thrombosis, or urinary tract obstruction) or bilateral (due to systemic hypotension, intratubular obstruction, or abnormalities in tubular function). Striated nephrograms may be unilateral or bilateral and are caused by ureteric obstruction, acute pyelonephritis, contusion, renal vein thrombosis, tubular obstruction, hypotension, and autosomal recessive polycystic kidney disease. The rim pattern is most often associated with renal infarction and occasionally with acute tubular necrosis and renal vein thrombosis. Careful evaluation of the CT nephrogram is an integral part of the abdominal CT examination.

This article has been cited by other articles:

				N. Takahashi, A. Kawashima, J. G. Fletcher, and S. T. Chari Renal Involvement in Patients with Autoimmune Pancreatitis: CT and MR Imaging Findings Radiology, March 1, 2007; 242(3): 791 - 801. [Abstract] [Full Text] [PDF]

				C. M. Rucker, C. O. Menias, and S. Bhalla Mimics of Renal Colic: Alternative Diagnoses at Unenhanced Helical CT RadioGraphics, October 1, 2004; 24(suppl_1): S11 - S28. [Abstract] [Full Text] [PDF]

				S. Sheth, J. C. Scatarige, K. M. Horton, F. M. Corl, and E. K. Fishman Current Concepts in the Diagnosis and Management of Renal Cell Carcinoma: Role of Multidetector CT and Three-dimensional CT RadioGraphics, October 1, 2001; 21(90001): S237 - 254. [Abstract] [Full Text] [PDF]

				R. Zissin, V. Amilineni, D. F. Lackner, W. S. Morse, and N. Srinivas Nonopacification of an Existing Kidney on Excretory Urography Am. J. Roentgenol., October 1, 2000; 175(4): 1187 - 1188. [Full Text] [PDF]

				A. Kawashima, C. M. Sandler, R. D. Ernst, E. P. Tamm, S. M. Goldman, and E. K. Fishman CT Evaluation of Renovascular Disease RadioGraphics, September 1, 2000; 20(5): 1321 - 1340. [Abstract] [Full Text] [PDF]

				B. A. Birnbaum, J. E. Jacobs, C. P. Langlotz, and P. Ramchandani Assessment of a Bolus-tracking Technique in Helical Renal CT to Optimize Nephrographic Phase Imaging Radiology, April 1, 1999; 211(1): 87 - 94. [Abstract] [Full Text]