CASE 11331 Published on 01.11.2013
0

Computed tomography perfusion imaging of renal infarction

Section

Uroradiology & genital male imaging

Case Type

Clinical Cases

Authors

Ummugulsum Bayraktutan1, Mecit Kantarci1, Hayri Ogul1, Aylin Okur1, Yeşim Kızrak1, Berhan Pirimoglu1, Suat Eren1

(1) Atatürk University,
School of Medicine,
Department of Radiology,
25090 Erzurum, Turkey
Email:akkanrad@hotmail.com
Connected authors
Patient

48 years, male

Categories
Area of Interest Abdomen ; Imaging Technique CT-Quantitative
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Clinical History
A 48-year-old man was evaluated in our department for abdominal pain after procedure of an embolization of an intrarenal AVF. He had a normal physical examination and urinalysis. Serum electrolytes were within normal ranges.
Imaging Findings
Contrast-enhanced abdominal CT scan showed non-enhanced parenchyma of the left kidney, which suggested left renal infarction and perfusion imaging provided some parameters including blood flow (BF), blood volume (BV) and permeability (PMB). On perfusion imaging these parameters decreased compared with the normal renal parenchyma. In the normal renal parenchyma the values of BF, BV and PMB were 97.91ml/100 ml/min, 52.01 ml/100 ml, 17.79 ml/100 ml/min, respectively (Figure 1). In the infarcted area these parameters decreased to 14.99 ml/100 ml/min, 8.16 ml/100 ml and 13.17 ml/100 ml/min, respectively (Figure 2).
Discussion
Computed tomography perfusion imaging is mainly used to assess blood flow to the head, and can assess absolute and relative blood flow to different sections of the brain [1]. Potentially, perfusion imaging can also be used for other organs such as the liver, pancreas, kidneys or lungs. Some parameters including blood flow rates, mean transit times, blood volume, time to peak perfusion and permeability can be measured with perfusion imaging. CT perfusion imaging can provide additional quantitative haemodynamic information about renal infarction as in our case. Perfusion imaging allows the numerical assessment of perfusion disturbances and of perfusion changes during therapy, thus this allows to determine the outcome of the patient and reversibility of the affected areas [1, 2]. Transcatheter embolization is the preferred treatment for most congenital and acquired renal arteriovenous fistulae (AVFs). A variety of materials has been used for embolization,
and this technique is especially effective for intrarenal AVFs [3].
Differential Diagnosis List
Renal infarction
Renal cell carcinoma
Rrenal angiomyolipoma
Final Diagnosis
Renal infarction
Case information
URL: https://www.eurorad.org/case/11331
DOI: 10.1594/EURORAD/CASE.11331
ISSN: 1563-4086
Figure 1

Perfusion CT imaging normal parameters

Perfusion CT imaging normal parameters
CT perfusion images of the normal renal parenchyma
Figure 2

CT perfusion imaging renal infarction

CT perfusion imaging renal infarction
CT perfusion images of renal infarction. Blood flow (BF), blood volume (BV) and permeability (PMB) decreased compared with the normal renal parenchyma.