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2.
Medicina (Kaunas) ; 57(1)2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33435540

RESUMO

The detection of a renal mass is a relatively frequent occurrence in the daily practice of any Radiology Department. The diagnostic approaches depend on whether the lesion is cystic or solid. Cystic lesions can be managed using the Bosniak classification, while management of solid lesions depends on whether the lesion is well-defined or infiltrative. The approach to well-defined lesions focuses mainly on the differentiation between renal cancer and benign tumors such as angiomyolipoma (AML) and oncocytoma. Differential diagnosis of infiltrative lesions is wider, including primary and secondary malignancies and inflammatory disease, and knowledge of the patient history is essential. Radiologists may establish a possible differential diagnosis based on the imaging features of the renal masses and the clinical history. The aim of this review is to present the contribution of the different imaging techniques and image guided biopsies in the diagnostic management of cystic and solid renal lesions.


Assuntos
Nefropatias/diagnóstico por imagem , Neoplasias Renais/diagnóstico por imagem , Abscesso/diagnóstico por imagem , Adenoma/diagnóstico por imagem , Adenoma Oxífilo/diagnóstico por imagem , Angiomiolipoma/diagnóstico por imagem , Carcinoma de Células Renais/diagnóstico por imagem , Carcinoma de Células de Transição/diagnóstico por imagem , Meios de Contraste , Cistos/classificação , Cistos/diagnóstico por imagem , Humanos , Leiomioma/diagnóstico por imagem , Linfoma/diagnóstico por imagem , Imagem por Ressonância Magnética , Plasmocitoma/diagnóstico por imagem , Pielonefrite/diagnóstico por imagem , Pielonefrite Xantogranulomatosa/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ultrassonografia , Ultrassonografia Doppler em Cores
3.
BMJ Case Rep ; 14(1)2021 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-33504529

RESUMO

A 47-year-old woman was admitted to our clinic for intensive pain in the left flank region. The transvaginal ultrasound showed a left adnexal solid mass with ascites. She had undergone surgical removal of skin melanoma in 2008, but in September 2019, intracardiac metastasis resulting from it had been discovered. CT performed in March 2020 had been negative for other metastases. A full abdomen ultrasound was not performed. During the night, the patient began to show signs and symptoms of hypovolaemic shock. The patient was urgently transferred to the operating room for a video laparoscopy. A vast left retroperitoneal haematoma was diagnosed along with voluminous enlargement of the left ovary. We proceeded with a left adnexectomy and blood transfusion. Subsequent contrast-enhanced CT revealed a left subcapsular, perirenal haematoma and a voluminous retroperitoneal haematoma. Kidney metastasis was also seen. The final histological diagnosis was metastatic amelanotic malignant melanoma of the ovary.


Assuntos
Hemorragia/diagnóstico por imagem , Nefropatias/diagnóstico por imagem , Neoplasias Renais/secundário , Melanoma Amelanótico/secundário , Melanoma/secundário , Neoplasias Ovarianas/secundário , Neoplasias Cutâneas/patologia , Transfusão de Sangue , Feminino , Hemorragia/etiologia , Humanos , Nefropatias/etiologia , Neoplasias Renais/complicações , Neoplasias Renais/diagnóstico por imagem , Melanoma/complicações , Melanoma/diagnóstico por imagem , Melanoma/cirurgia , Melanoma Amelanótico/complicações , Melanoma Amelanótico/diagnóstico por imagem , Melanoma Amelanótico/cirurgia , Pessoa de Meia-Idade , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Ovarianas/cirurgia , Espaço Retroperitoneal , Choque/etiologia , Tomografia Computadorizada por Raios X
4.
Nefrología (Madrid) ; 40(6): 623-633, nov.-dic. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-197198

RESUMO

La ecografía es una herramienta esencial en el manejo del paciente nefrológico que permite el diagnóstico, el seguimiento y la realización de intervencionismo sobre el riñón. La utilidad de los ultrasonidos en Nefrología no se circunscribe exclusivamente al estudio ecográfico del riñón. Mediante ecografía el nefrólogo puede, además, optimizar el manejo de la fístula arteriovenosa para hemodiálisis, medir el riesgo cardiovascular (grosor íntima-media), implantar catéteres centrales para hemodiálisis ecoguiados y ayudar en la colocación de los peritoneales, así como calcular la volemia del paciente mediante ecografía cardiaca básica, ecografía de la vena cava inferior y pulmonar. Desde el Grupo de Trabajo en Nefrología Diagnóstica e Intervencionista (GNDI) de la Sociedad Española de Nefrología (SEN) hemos elaborado este documento de consenso en el que se resumen las principales aplicaciones de la ecografía en Nefrología, incluyendo los requisitos técnicos básicos necesarios, el marco normativo y el nivel de capacitación de los nefrólogos en esta materia. El objetivo de este trabajo es promover la inclusión de la ecografía, tanto diagnóstica como intervencionista, en la práctica clínica habitual del nefrólogo y en la cartera de servicios de Nefrología con la finalidad de ofrecer un manejo diligente, eficiente e integral al paciente nefrológico


Ultrasound is an essential tool in the management of the nephrological patient allowing the diagnosis, monitoring and performance of kidney intervention. However, the usefulness of ultrasound in the hands of the nephrologist is not limited exclusively to the ultrasound study of the kidney. By ultrasound, the nephrologist can also optimize the management of arteriovenous fistula for hemodialysis, measure cardiovascular risk (mean intimate thickness), implant central catheters for ultrasound-guided HD, as well as the patient's volemia using basic cardiac ultrasound, ultrasound of the cava inferior vein and lungs. From the Working Group on Interventional Nephrology (GNDI) of the Spanish Society of Nephrology (SEN) we have prepared this consensus document that summarizes the main applications of ultrasound to Nephrology, including the necessary basic technical requirements, the framework normative and the level of training of nephrologists in this area. The objective of this work is to promote the inclusion of ultrasound, both diagnostic and interventional, in the usual clinical practice of the nephrologist and in the Nephrology Services portfolio with the final objective of offering diligent, efficient and comprehensive management to the nephrological patient


Assuntos
Humanos , Nefrologia/educação , Ultrassonografia/normas , Nefropatias/diagnóstico por imagem , Sociedades Médicas , Ultrassonografia/métodos , Espanha
5.
Arch Esp Urol ; 73(9): 862-863, 2020 Nov.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33144543

RESUMO

A 62 year old man with a history of weight loss and left flank pain did a renal ultrasound that showed a heterogeneous formation involving the left kidney compatible with a solid lesion...


Assuntos
Nefropatias , Neoplasias Renais , Lipomatose , Humanos , Rim/diagnóstico por imagem , Nefropatias/diagnóstico por imagem , Nefropatias/etiologia , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/cirurgia , Lipomatose/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Ultrassonografia
6.
Reumatol. clín. (Barc.) ; 16(5,pt.1): 359-361, sept.-oct. 2020. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-195894

RESUMO

We report a case of acute left ventricular dysfunction due to myocarditis, in the setting of a scleroderma renal crisis. The case is particularly intriguing for the favorable outcome of both symptoms and heart function following immunosuppressive therapy. We also highlight the changes observed over time with image techniques as well as in electrocardiograms


Presentamos un caso de disfunción ventricular izquierda secundaria a miocarditis en el contexto de una crisis renal esclerodérmica. Su principal atracción reside en la gran mejoría experimentada por el paciente, no solo en lo que a los síntomas se refiere sino también en su función cardiaca, tras el inicio del tratamiento inmunosupresor. Es muy llamativa la evolución radiológica y electrocardiográfica documentada


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Miocardite/complicações , Nefropatias/complicações , Nefropatias/diagnóstico , Disfunção Ventricular Esquerda/etiologia , Disfunção Ventricular Esquerda/diagnóstico , Ciclofosfamida/uso terapêutico , Imunossupressores/uso terapêutico , Imunoglobulinas Intravenosas/uso terapêutico , Nefropatias/diagnóstico por imagem , Eletrocardiografia , Disfunção Ventricular Esquerda/diagnóstico por imagem , Imunossupressão
7.
Medicine (Baltimore) ; 99(36): e22038, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899061

RESUMO

The effectiveness of diethylenetriamine pentaacetic acid scan is regularly monitored for the assessment of any potential modifications in treatment responses or kidney functions in the pediatric population.This study attempts to compare the usefulness of diethylenetriamine pentaacetic acid and ultrasound imaging of renal disorders among paediatric patients.A retrospective observational study was conducted by enrolling 106 children. The demographic details such as: participant's age, gender, and the history of renal disease of each patient were recorded. Patients were administered radiopharmaceuticals in a fixed dose and were later subjected to computed tomography (CT) scan. The obtained data was analysed using descriptive statistics.Findings indicated increased sensitivity for CT (61.20%); whereas, a major decrease in specificity (23.68%) was observed. Comparison of Single-photon emission CT (SPECT) and CT findings revealed the increased sensitivity (90.90%) for ultrasound; whereas, there was a slight decrease in the specificity (40%) for SPECT. However, SPECT findings show 91% sensitivity among patients with 71.42% positive predictive value. Moreover, an increase in sensitivity for CT (61.20%), followed by a major decrease in specificity (23.68%) was observed.Ultrasonography has been proved to be the safest and the most effective method for the diagnosis and the treatment of most renal disorders, due to the higher predictive value of SPECT scans. It is thus suggested that patients with ureteral calculi should be diagnosed with renal scintigraphy and unenhanced helical computerized tomography.


Assuntos
Nefropatias/diagnóstico por imagem , Ácido Pentético/administração & dosagem , Cintilografia/métodos , Ultrassonografia/métodos , Cálculos Ureterais/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Nefropatias/fisiopatologia , Masculino , Medicina Nuclear/métodos , Valor Preditivo dos Testes , Compostos Radiofarmacêuticos/administração & dosagem , Estudos Retrospectivos , Sensibilidade e Especificidade , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tomografia Computadorizada por Raios X/métodos
9.
Lakartidningen ; 1172020 09 08.
Artigo em Sueco | MEDLINE | ID: mdl-32897536

RESUMO

Symtomatic mobile kidney is a rare condition and diagnosis is difficult. Typical symptoms are position dependent back-flank-abdominal pain with increase of pain when walking, jogging and lifting or other physical activities which increase the descent of the kidney. Triple diagnostic with typical pain history, an intravenous pyelography with a renal descent of ≥ 2 lumbar vertebral heights in the erect position, and an ultrasound with a positive pain provocation can establish the diagnosis of symptomatic mobile kidney. In our study nephropexy gives freedom of pain for 75% of patients and substantial relief for 15% of patients with severe pain.


Assuntos
Nefropatias , Liberdade , Humanos , Rim , Nefropatias/diagnóstico por imagem , Ultrassonografia , Urografia
10.
Radiol Clin North Am ; 58(5): 909-923, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32792123

RESUMO

Acute pyelonephritis is a bacterial infection of the renal parenchyma and collecting system. Diagnosis is based on clinical findings of fever, flank pain, and urinary tract infection. Computed tomography findings include renal enlargement with wedge-shaped heterogeneous areas of decreased enhancement, known as a "striated nephrogram." Imaging is primarily used to diagnose complications such as emphysematous pyelonephritis, renal abscess, and pyonephrosis. Chronic pyelonephritis can have varying appearances on imaging ranging from xanthogranulomatous pyelonephritis or, in extreme cases, renal replacement lipomatosis.


Assuntos
Diagnóstico por Imagem/métodos , Nefropatias/diagnóstico por imagem , Pielonefrite/diagnóstico por imagem , Infecções Urinárias/diagnóstico por imagem , Humanos , Infecções/diagnóstico por imagem , Rim/diagnóstico por imagem , Imagem por Ressonância Magnética , Radiografia , Tomografia Computadorizada por Raios X , Ultrassonografia , Sistema Urinário/diagnóstico por imagem
13.
Eur J Vasc Endovasc Surg ; 60(3): 395-401, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32665199

RESUMO

OBJECTIVE: The objective of this prospective single centre study was to assess whether branches and fenestrations have different outcomes on renal function in the early phase. METHODS: From March 2018 to June 2019, 67 patients who underwent elective fenestrated and branched endovascular aneurysm repair (F/BEVAR) procedures were enrolled in this study. The patients were divided into two groups according to the renal bridging component configuration (fenestration vs. branch). All of them underwent dynamic renal scintigraphy with 99mTc diethylenetriaminepentaacetic acid (DTPA), two weeks pre-operatively, and three months and one year post-operatively. The primary end points were peri-procedural technical success, 30 day major adverse events, differences in glomerular filtration rate (GFR) between the branch and fenestration configurations, and variations between the pre-operative and the post-operative dynamic renal scintigraphy. RESULTS: Overall, 135 kidneys were analysed: 63 in the 32 patients treated with fenestrations, and 72 in the 35 patients treated with branches; the mean GFR on baseline scintigraphy was 58.4 ± 30.9 mL/min in the fenestration group, and 65.1 ± 29.2 mL/min in the branch group. Only kidneys associated with a patent fenestration/branch were included in the split GFR final analysis. The mean total GFR at three month scintigraphy decreased by 6.0 ± 2.9 mL/min in the fenestration group and by 23.4 ± 6.4 mL/min in the branch group. The split GFR decreased by 3.5 ± 0.6 mL/min in the fenestration group, and by 15.4 ± 5.4 mL/min in the branch group. The GFR decrease remained stable at one year. CONCLUSION: In this study, the use of branches for renal arteries during F/BEVAR resulted in a greater decrease in the GFR than in those patients who were treated with fenestrations alone. The scintigraphic alterations were evident at an early phase.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular/instrumentação , Prótese Vascular , Procedimentos Endovasculares/instrumentação , Nefropatias/diagnóstico por imagem , Cintilografia , Artéria Renal/cirurgia , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/fisiopatologia , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/fisiopatologia , Implante de Prótese Vascular/efeitos adversos , Procedimentos Endovasculares/efeitos adversos , Feminino , Taxa de Filtração Glomerular , Humanos , Nefropatias/etiologia , Nefropatias/fisiopatologia , Masculino , Valor Preditivo dos Testes , Estudos Prospectivos , Desenho de Prótese , Compostos Radiofarmacêuticos/administração & dosagem , Artéria Renal/diagnóstico por imagem , Artéria Renal/fisiopatologia , Pentetato de Tecnécio Tc 99m/administração & dosagem , Fatores de Tempo , Resultado do Tratamento
14.
Methodist Debakey Cardiovasc J ; 16(2): 170-174, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32670481

RESUMO

The column in this issue is supplied by Juan Jose Olivero, MD, who recently retired as a nephrologist at Houston Methodist Hospital and member of the hospital's Nephrology Training Program. Dr. Olivero obtained his medical degree from the University of San Carlos School of Medicine in Guatemala, Central America, and completed his residency and nephrology fellowship at Baylor College of Medicine in Houston, Texas.


Assuntos
Nefropatias/diagnóstico por imagem , Rim/diagnóstico por imagem , Urografia , Adulto , Cistografia , Taxa de Filtração Glomerular , Humanos , Rim/fisiopatologia , Nefropatias/fisiopatologia , Nefropatias/terapia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Adulto Jovem
15.
AJR Am J Roentgenol ; 215(2): 406-412, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32374662

RESUMO

OBJECTIVE. IgG4-related disease is characterized by extensive infiltration of IgG4-positive plasma cells and fibrosis in various organs. The objective of this study is to investigate CT findings of IgG4-related lesions involving the upper urinary tract and compare them with those of urothelial carcinomas. MATERIALS AND METHODS. This study reviewed pretreatment CT images of 13 consecutive patients with IgG4-related disease with upper urinary tract lesions and 80 consecutive patients with urothelial carcinomas. The findings assessed were laterality, location, growth pattern, margins, internal structure, presence of calcification and lipid component, enhancement pattern, and extraurinary findings. RESULTS. Bilaterality (p < 0.0001), an extramural growth pattern (p < 0.0001), a greater number of affected segments (p = 0.04), and a gradual dynamic enhancement pattern (p < 0.001) were significantly more frequent in patients with IgG4-related disease. With regard to extraurinary findings, paraaortic fat stranding (p = 0.03), presacral fat stranding (p < 0.001), fat stranding of the pelvic walls (p < 0.001), and aortic involvement (p < 0.001) were seen more frequently in patients with IgG4-related disease; on the other hand, there was no statistically significant difference in terms of frequency of pancreatic involvement. Hydronephrosis and renal involvement were seen more frequently in patients with urothelial carcinoma, although the difference was not statistically significant. CONCLUSION. CT findings suggestive of IgG4-related upper urinary tract lesions in comparison with urothelial carcinoma are bilateral and have a longer urinary tract involvement and exhibit an extramural growth pattern, ill-defined margins, a gradual enhancement pattern, aortic involvement, and fat stranding in the paraaortic, presacral, or pelvic wall areas.


Assuntos
Carcinoma de Células de Transição/diagnóstico por imagem , Doença Relacionada a Imunoglobulina G4/diagnóstico por imagem , Nefropatias/diagnóstico por imagem , Neoplasias Renais/tratamento farmacológico , Doenças Ureterais/diagnóstico por imagem , Neoplasias Ureterais/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células de Transição/etiologia , Feminino , Humanos , Doença Relacionada a Imunoglobulina G4/complicações , Nefropatias/etiologia , Neoplasias Renais/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Doenças Ureterais/etiologia , Neoplasias Ureterais/etiologia
16.
Korean J Radiol ; 21(5): 588-597, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32323504

RESUMO

OBJECTIVE: To investigate the value of combined chemical exchange saturation transfer (CEST) and conventional magnetization transfer imaging (MT) in detecting metabolic and structural changes of renal fibrosis in rats with unilateral ureteral obstruction (UUO) at 3T MRI. MATERIALS AND METHODS: Thirty-five Sprague-Dawley rats underwent UUO surgery (n = 25) or sham surgery (n = 10). The obstructed and contralateral kidneys were evaluated on days 1, 3, 5, and 7 after surgery. After CEST and MT examinations, 18F-labeled fluoro-2-deoxyglucose positron emission tomography was performed to quantify glucose metabolism. Fibrosis was measured by histology and western blots. Correlations were compared between asymmetrical magnetization transfer ratio at 1.2 ppm (MTRasym(1.2ppm)) derived from CEST and maximum standard uptake value (SUVmax) and between magnetization transfer ratio (MTR) derived from MT and alpha-smooth muscle actin (α-SMA). RESULTS: On days 3 and 7, MTRasym(1.2ppm) and MTR of UUO renal cortex and medulla were significantly different from those of contralateral kidneys (p < 0.05). On day 7, MTRasym(1.2ppm) and MTR of UUO renal cortex and medulla were significantly different from those of sham-operated kidneys (p < 0.05). The MTRasym(1.2ppm) of UUO renal medulla was fairly negatively correlated with SUVmax (r = -0.350, p = 0.021), whereas MTR of UUO renal medulla was strongly negatively correlated with α-SMA (r = -0.744, p < 0.001). CONCLUSION: CEST and MT could provide metabolic and structural information for comprehensive assessment of renal fibrosis in UUO rats in 3T MRI and may aid in clinical monitoring of renal fibrosis in patients with chronic kidney disease.


Assuntos
Fibrose/diagnóstico por imagem , Nefropatias/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Tomografia por Emissão de Pósitrons/métodos , Obstrução Ureteral/diagnóstico por imagem , Animais , Modelos Animais de Doenças , Fibrose/patologia , Humanos , Córtex Renal/diagnóstico por imagem , Córtex Renal/patologia , Nefropatias/patologia , Medula Renal/diagnóstico por imagem , Medula Renal/patologia , Masculino , Ratos , Ratos Sprague-Dawley , Obstrução Ureteral/patologia
17.
AJR Am J Roentgenol ; 215(1): 142-147, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32255686

RESUMO

OBJECTIVE. The objective of our study was to develop a novel method to estimate single-kidney glomerular filtration rate (GFR) using a combination of contrast-enhanced CT and serum creatinine (SCr) values and to validate the resulting estimated glomerular filtration rates (eGFRs) by comparing them with the single-kidney Gates GFR, which is based on renal dynamic imaging. MATERIALS AND METHODS. Sixty-two patients with asymmetric renal disease who underwent unenhanced and triphasic contrast-enhanced CT of the kidneys, 99mTc-diethylenetriamine pentaacetic acid renal dynamic imaging, and SCr testing within 1 week were retrospectively included. The eGFR was split into single-kidney GFRs of the left and right kidneys by a proportionality factor derived from the products of renal volume and CT number increments of the multiphasic CT images, which produced unenhanced phase (yielded by the renal volume proportional factor alone), arterial phase, venous phase, and nephrographic phase CT split eGFRs. The four CT split eGFRs were compared with the Gates GFR using the paired-sample t test, Pearson correlation analysis, and Bland-Altman analysis. RESULTS. Correlation coefficients and 95% CIs between the four CT split eGFRs and Gates GFR were as follows: unenhanced phase, 0.729 (95% CI, 0.626-0.805); arterial phase, 0.781 (95% CI, 0.685-0.849); venous phase, 0.788 (95% CI, 0.690-0.839); and nephrographic phase, 0.842 (95% CI, 0.758-0.902) (all, p < 0.001). The paired differences between the CT split eGFRs and Gates GFR were as follows: unenhanced phase, 2.04 ± 10.85 (95% CI, 0.01-4.07) mL/min/1.73 m2; arterial phase, 2.04 ± 10.56 (95% CI, 0.06-4.02) mL/min/1.73 m2; venous phase, 2.04 ± 10.04 (95% CI, 0.16-3.92) mL/min/1.73 m2; and nephrographic phase, 2.04 ± 8.92 (95% CI, 0.37-3.71) mL/min/1.73 m2. These results suggest a maximum deviation from the Gates GFR of ± 44.9% for the unenhanced phase eGFR, ± 43.7% for the arterial phase eGFR, ± 41.6% for the venous phase eGFR, and ± 36.9% for nephrographic phase eGFR. CONCLUSION. Split renal function can be estimated using a combination of contrast-enhanced CT and SCr values to calculate eGFR. The CT images of the nephrographic phase may be the optimal choice to use in this proposed method.


Assuntos
Creatinina/sangue , Taxa de Filtração Glomerular , Nefropatias/diagnóstico por imagem , Nefropatias/fisiopatologia , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Meios de Contraste , Feminino , Humanos , Nefropatias/sangue , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Doses de Radiação , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Pentetato de Tecnécio Tc 99m
20.
Int Braz J Urol ; 46(2): 194-202, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32022507

RESUMO

OBJECTIVE: To evaluate usage of renal artery embolization (RAE) for renal injuries and discuss the indications for this treatment. MATERIALS AND METHODS: A retrospective study was performed evaluating the electronic medical records of all patients with renal trauma admitted to two major comprehensive hospitals in Shantou city from January 2006 to December 2015. RESULTS: There were 264 and 304 renal traumatic patients admitted to hospital A and B, respectively. LGRT was the reason for presentation in the majority of patients (522, 91.9%). A total of 534 (94.0%) patients were treated conservatively. RAE was performed in 9 patients from 2012 to 2015 at hospital A, including in 6 patients (6/9, 66.7%) with LGRT, and 3 patients (3/9, 33.3%) with HGRT. No patient underwent interventional therapy (RAE) at hospital B during the same period. No significant differences in the operative rate of hospital A were observed between the two time periods (2006-2011 and 2012-2015). The operative rate for LGRT between the two hospitals from 2006 to 2011 and 2012 to 2015 was not significantly different. Hospital A showed a significant decrease in the rate of conservative treatment for patients with LGRT. In the univariate and multivariate analyses, the AAST renal grade both were significantly associated with undergoing RAE. CONCLUSIONS: LGRT was present in the majority of patients, and most cases of renal trauma could be treated with conservative treatment. RAE was well utilized for the treatment of renal trauma. However, some patients with LGRT were treated with unnecessary interventional therapy.


Assuntos
Embolização Terapêutica/métodos , Nefropatias/terapia , Rim/irrigação sanguínea , Artéria Renal/lesões , Adolescente , Adulto , Idoso , Feminino , Humanos , Nefropatias/diagnóstico por imagem , Nefropatias/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índices de Gravidade do Trauma , Resultado do Tratamento , Adulto Jovem
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