Rongde Wu, Presenter: Nothing to Disclose

Rui Ma, Abstract Co-Author: Nothing to Disclose

Cheng Liu MD, Abstract Co-Author: Nothing to Disclose

To investigate value of spiral CT for renal traumatic injury.

A retrospective study was done on 34 cases with renal traumatic injury in children(age 2y to 16y) detected by USG and spiral CT. 34 cases were done USG first, then multi-slice spiral CT was done. Multi-slice spiral CT were used for scanning kidney and ureter, which include non-enhanced and enhancement scan. 33 cases were found renal injuries by USG and spiral CT resulted from blunt trauma,1 case was stab wound renal injury. CT scan protocol:Pitch 1.0～1.5,routine slice thickness 5.0mm, slice thickness for postprocessing was 1.5～3.2mm with slice increment 0.8～1.8mm.MPR,MIP,VR were used for postproscessing in excretory phase images. Conservative management (in 29 cases) or surgery management(in 5 cases) were adopted. USG follow-up were done on 34 cases after management. Compare to follow-up results,the diagnosis accuracy of USG and spiral CT for renal injurys were analysed respectively.

20 cases were diagnosed by USG as renal contusion with or without subcapsular hematoma, as well as CT diagnosis, and conservative management was adopted for them except in one stab wound case with subcapsular hematoma.Other 14 cases were found parenchymal laceration on USG and CT,which without urinary extravasation(10 cases in USG,but 5 cases in CT), with mild extravasation(non in USG but 5 cases in CT),with severe extravasation in other 4 cases on USG and CT.These 14 cases ureters lumen detailed condition could not be reliably acquired from USG, but on CT,10 cases were showed normal ureter opacity,4 cases abnormal ureter opacity which implied compression or UPJ avulsion. The 34 cases were all recovered well (in 29) or kidney salvaged(in 5) confrimed by USG follow-up.

Multi-slice spiral CT could acurately depict renal traumatic injury. Compare to USG,it was more sensitive for mild extravasation,more acurate for depicting abnormal ureters condition.Conservative management was suitable for most of lacerations except large extravasation.

USG can reliably depict mild renal traumatic injury.If renal laceration was found by USG, CT should be recommend for more acurate evaluation,esp. for ureters.

Wu, R, Ma, R, Liu, C, Evaluation by Spiral CT on Traumatic Renal Injury in Children.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5014757.html