[Spiral scanners: the key to imaging of kidney injuries]

Whatever the mechanism or extent of other lesions, ultrasonography is essential in evaluating damage to the kidney after abdominal trauma in order to identify renal devascularization, fracture or fragment separation, to recognize the different blood or urine components in perirenal collections, to search for associated or prior lesions, and to obtain a baseline measurement for future follow-up. Progression introduced with spiral scans now provides 3-D images for then entire organ at different times during contrast product diffusion. The corticovascular time is used to analyse the renal pedicle and cortical vascularization; the tubular time is ideal for analysing fractures and dislocations; the calicial or excretory time, together with urography films give information on extravasation of contrast product, the upper tract and the bladder. 3-D images allow reconstructions in all three plans for the different structures, faciliting interpretation. Spiral scan should be available in all emergency centers to guarantee quality management or renal trauma.