Radiographic evaluation of blunt renal trauma

Abstract

18名の鈍的腎損傷の患者における画像診断法の臨床的意義を検討した.患者は11名がminor injuryで, 7名がmajor injuryであった.このうち14名が保存的治療を, 4名が手術的治療を受けた.静脈性腎盂造影は健側腎の存在が把握できるために有用であるが, しばしば損傷の範囲が不確かなことが多く, これは過大評価が多く, 過小評価が稀な傾向を示した.CTエックス線検査は損傷の範囲, 腎周囲血腫および併発する後腹膜や腹部外傷が, 静脈性腎盂造影に比べ明らかに正確に診断された.血管造影は動脈性出血の部位を同定するのに有用であった

Radiographic evaluation was performed on 18 patients with blunt renal trauma. Of 18 patients 11 had minor injury. Four of 11 patients with minor injury had a normal intravenous pyelogram (IVP), and other 7 were confirmed to have minor renal injury by computed tomographic (CT) scan. Seven patients had major injury. Six patients were diagnosed by both IVP and CT, and five by angiography. CT scan was reliable in major injury and had the high staging accuracy. Angiography was useful in specific patients. Therefore, we conclude that IVP or CT scan should be performed as the initial evaluation, and CT scan or angiography might be used as the second examination in selected patients.