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Renal subcapsular rim sign. Radionuclide pattern.

R Howman-Giles, M Gett, P Roy

    Clinical Nuclear Medicine
    |April 1, 1986
    PubMed
    Summary
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    The renal cortical rim sign, a peripheral nephrogram, indicates nonfunctioning kidneys due to collateral circulation. This sign on renal scans can help diagnose neonatal renal vein thrombosis.

    Area of Science:

    • Radiology
    • Nuclear Medicine
    • Pediatric Nephrology

    Background:

    • The renal cortical rim sign is a radiological finding characterized by a thin peripheral nephrogram (2-4 mm).
    • It results from peri-renal capsular collateral circulation in a nonfunctioning kidney.
    • Radionuclide imaging is crucial for assessing renal function.

    Observation:

    • A neonate with renal vein thrombosis presented with a distinct rim sign on a Technetium DTPA renal scan.
    • This sign was most effectively visualized during the early blood pool phase of the scan.
    • The presence of radioactivity in the blood pool aided in identifying the rim sign.

    Findings:

    • The renal cortical rim sign was observed in a neonate with renal vein thrombosis.
    • This sign represents collateral circulation supplying the renal capsule in an otherwise nonfunctioning kidney.

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  • The sign is distinguishable from severe hydronephrosis or multicystic kidney disease.

    • Implications:

    • The renal cortical rim sign on renal scans can aid in diagnosing neonatal renal vein thrombosis.
    • Differentiating the rim sign from other conditions like hydronephrosis is essential for accurate diagnosis.
    • Early visualization during the blood pool phase enhances the diagnostic utility of the rim sign.