Value of dual-phase multislice CT prior to minimally invasive therapy of iatrogenic renal injuries.
OBJECTIVE
To evaluate the diagnostic impact of multislice computed tomography (MSCT) in treatment planning prior to transarterial coil embolization of iatrogenic renal injuries.


METHODS
Nine patients (median age 54 years, range 36-66) with iatrogenic renal vascular injury were treated with superselective coil embolization. Prior to therapy, a dual-phase (40 and 120 seconds) contrast-enhanced MSCT was applied in 6 patients. Seven patients underwent renal ultrasonography. Multiplanar reconstructions of the MSCT scans were used to affirm ongoing bleeding and to localize the bleeding site at the level of the segmental or interlobar artery. MSCT and angiographic findings were compared to evaluate the accuracy of MSCT in the detection of the bleeding source prior to therapy.


RESULTS
Multiplanar reconstructions of early-phase MSCT scans allowed precise identification of the bleeding interlobar or segmental artery in all 6 cases prior to angiography. In one case, MSCT was even able to detect a source of bleeding that was not revealed by selective renal angiography.


CONCLUSIONS
Multiplanar reconstructions of MSCT data demonstrate not only the presence of hematoma but also confirm ongoing bleeding and the location of the feeder artery prior to minimally invasive therapy.
Kluner
Claudia
C
Department of Radiology, Charité University Hospital, Berlin, Germany. claudia.kluner@charite.de
Rogalla
Patrik
P
Gralla
Oliver
O
Elgeti
Thomas
T
Hamm
Bernd
B
Kroencke
Thomas
T
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006470:Hemorrhage / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D007049:Iatrogenic Disease; D007674:Kidney Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016896:Treatment Outcome