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Spontaneous perinephric hemorrhage: imaging and management
R J Zagoria1, R B Dyer, D G Assimos
1Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27103.
The Journal of Urology
|March 1, 1991
Summary
Spontaneous perinephric hemorrhage can be linked to various underlying conditions. While CT and MRI are accurate for diagnosis, arteriography may be needed to identify the cause, especially when initial imaging is inconclusive.
Area of Science:
- Urology
- Radiology
- Oncology
Background:
- Spontaneous perinephric hemorrhage is a rare condition.
- It is often associated with underlying renal or systemic diseases.
Purpose of the Study:
- To evaluate the diagnostic accuracy of imaging modalities for spontaneous perinephric hemorrhage.
- To identify the spectrum of underlying pathologies associated with this condition.
Main Methods:
- Retrospective review of 10 patients with spontaneous perinephric hemorrhage.
- Analysis of imaging findings from computerized tomography (CT), magnetic resonance imaging (MRI), and arteriography.
- Correlation of imaging findings with pathological diagnoses.
Main Results:
- Underlying diseases included renal cell carcinoma (5), angiomyolipoma (2), melanoma (1), periarteritis nodosa (1), and portal hypertension (1).
- CT alone failed to identify the etiology in 50% of cases.
- Arteriography identified underlying lesions in 80% of cases where CT was inconclusive.
- CT and MRI are accurate for diagnosing hemorrhage, but identifying the cause can be challenging due to blood obscuration.
Conclusions:
- CT is the primary imaging modality for suspected spontaneous perinephric hemorrhage.
- Arteriography is recommended when CT does not reveal a renal mass.
- Follow-up thin-slice CT may be useful for stable patients when initial imaging is non-diagnostic.