Imaging in renal trauma.

Area of Science:

• Radiology
• Trauma Surgery
• Urology

Background:

• Renal injuries are graded using the American Association for the Surgery of Trauma classification.
• Various imaging modalities exist for assessing renal injury, each with specific advantages and limitations.

Purpose of the Study:

• To review the spectrum of renal injuries in a trauma setting.
• To delineate the roles and limitations of different imaging modalities in evaluating renal trauma.

Main Methods:

• Review of imaging modalities including ultrasonography, selective renal arteriography, retrograde pyelography, magnetic resonance imaging, and multidetector computed tomography.
• Discussion of the diagnostic and interventional utility of each modality.
• Emphasis on the integration of imaging findings with clinical information for patient management.

Main Results:

• Plain radiographs and intravenous urography are not recommended for suspected renal injury evaluation.
• Ultrasonography is valuable for monitoring urinoma formation and guiding drainage.
• Selective renal arteriography and retrograde pyelography have primarily interventional roles.
• Magnetic resonance imaging has no role in acute renal injury assessment.
• Multidetector computed tomography is the gold standard for evaluating renal trauma, including complex and penetrating injuries.

Conclusions:

• Multidetector computed tomography is the imaging modality of choice for renal trauma.
• The choice of imaging modality depends on the specific clinical scenario and suspected injury.
• Integrating imaging results with clinical data is crucial for effective patient management.