Renal trauma: radiological studies. Comparison of urography, computed tomography, angiography, and radionuclide studies.

Abstract

Excretory urography, computed radionuclide urography, angiography, and both conventional and dynamic computed tomography (CT) were compared with regard to accuracy, sensitivity, and specificity in 388 patients with renal trauma. Used as the triage examination, urography established the absence of significant renal injury with an accuracy of 87%, obviating further evaluation. Dynamic CT proved to be the best method of assessing parenchymal injuries, establishing the correct diagnosis in 129 out of 130 cases compared to 116/130 for conventional CT. Angiography was the procedure of choice for diagnosis and categorization of renal artery injuries, which were diagnosed correctly in all 43 cases. The choice between dynamic CT and angiography as the second examination rests upon careful evaluation of clinical and urographic findings for signs of renal artery injury which would mandate angiographic assessment.