Kidney, Ureter, Adrenal Gland

  • Michael K. Scherr
  • Ulrich Linsenmaier
Part of the Medical Radiology book series (MEDRAD)


Today, multidetector computer tomography (MDCT), with its fast gantry rotation, enables large body volumes to be scanned with high temporal and spatial resolution. The fast rates of data acquisition and reconstruction result in multiphase protocols with short time intervals between consecutive scan series following the administration of a single bolus of intravenous contrast material (CM). Large scans obtained within a single breath-hold are possible and even the image data of non-cooperative or emergency patients are of acceptable quality. The acquired thin-slice raw data with isotropic sub-millimeter voxels can be visualized using different reconstruction algorithms and reformatted in all three spatial planes. The advantages of MDCT in the imaging of urologic emergencies are the excellent visualization of acute arterial and venous pathologies, detailed assessment of adrenal and renal parenchyma, and the precise depiction of the urinary tract (Foley WD (2002) Special focus session: multidetector CT: abdominal visceral imaging. Radiographics 22:701–719). Thus, in trauma and non-trauma settings a highly informative visualization of parenchymal patterns, bleeding, inflammatory disease is provided, allowing the differentiation of obstructive, post-traumatic, or post-therapeutic pathologies along the upper and lower urinary tract and including the adjacent retroperitoneal structures. Based on these MDCT findings, adequate decision-making in acute trauma, therapy planning, and interventional or surgical procedure planning can be carried out.


Renal Artery Adrenal Gland Inferior Vena Cava Renal Vein Adrenal Vein 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Akbar SA, Mortele KJ, Baeyens K, Kekelidze M, Silverman SG (2004) Multidetector CT urography: techniques, clinical applications, and pitfalls. Semin Ultrasound CT MR 25:41–54PubMedCrossRefGoogle Scholar
  2. Alonso RC, Nacenta SB, Martinez PD, Guerrero AS, Fuentes CG (2009) Kidney in danger: CT findings of blunt and penetrating renal trauma. Radiographics 29:2033–2053PubMedCrossRefGoogle Scholar
  3. Browne RF, Zwirewich C, Torreggiani WC (2004) Imaging of urinary tract infection in the adult. Eur Radiol 14 (Suppl3):168–183Google Scholar
  4. Craig WD, Wagner BJ, Travis MD (2008) Pyelonephritis: radiologic-pathologic review. Radiographics 28:255–277 (quiz 327-8)PubMedCrossRefGoogle Scholar
  5. Demertzis J, Menias CO (2007) State of the art: imaging of renal infections. Emerg Radiol 14:13–22PubMedCrossRefGoogle Scholar
  6. Federle MP (2000) Renal trauma. In: Pollack HM, McClennan BL (eds) Clinical urography. WB Saunders, Philadelphia, pp 1772–1784 (P 13)Google Scholar
  7. Fleischmann D (2003) Multiple detector-row CT angiography of the renal and mesenteric vessels. Eur J Radiol 45 (Suppl1):S79–S87PubMedCrossRefGoogle Scholar
  8. Foley WD (2002) Special focus session: multidetector CT: abdominal visceral imaging. Radiographics 22:701–719PubMedGoogle Scholar
  9. Foley WD (2003) Renal MDCT. Eur J Radiol 45 (Suppl1):S73–S78PubMedCrossRefGoogle Scholar
  10. Furlan A, Federle MP, Yealy DM, Averch TD, Pealer K (2008) Nonobstructing renal stones on unenhanced CT: a real cause for renal colic? AJR Am J Roentgenol 190:W125–W127PubMedCrossRefGoogle Scholar
  11. Heneghan JP, Dalrymple NC, Verga M, Rosenfield AT, Smith RC (1997) Soft-tissue “rim” sign in the diagnosis of ureteral calculi with use of unenhanced helical CT. Radiology 202:709–711PubMedGoogle Scholar
  12. Heyns CF (2004) Renal trauma: indications for imaging and surgical exploration. BJU Int 93:1165–1170PubMedCrossRefGoogle Scholar
  13. Kawashima A, LeRoy AJ (2003) Radiologic evaluation of patients with renal infections. Infect Dis Clin North Am 17:433–456PubMedCrossRefGoogle Scholar
  14. Kawashima A, Sandler CM, Corriere JN Jr, Rodgers BM, Goldman SM (1997) Ureteropelvic junction injuries secondary to blunt abdominal trauma. Radiology 205:487–492PubMedGoogle Scholar
  15. Kawashima A, Sandler CM, Ernst RD et al (1999) Imaging of nontraumatic hemorrhage of the adrenal gland. Radiographics 19:949–963PubMedGoogle Scholar
  16. Kawashima A, Sandler CM, Corl FM et al (2001) Imaging of renal trauma: a comprehensive review. Radiographics 21:557–574PubMedGoogle Scholar
  17. Kemper J, Regier M, Stork A, Adam G, Nolte-Ernsting C (2006) Improved visualization of the urinary tract in multidetector CT urography (MDCTU): analysis of individual acquisition delay and opacification using furosemide and low-dose test images. J Comput Assist Tomogr 30:751–757PubMedCrossRefGoogle Scholar
  18. Kocakoc E, Bhatt S, Dogra VS (2005) Renal multidector row CT. Radiol Clin North Am 43:1021–1047 viiiPubMedCrossRefGoogle Scholar
  19. Kuan JK, Wright JL, Nathens AB, Rivara FP, Wessells H (2006) American association for the surgery of trauma organ injury scale for kidney injuries predicts nephrectomy, dialysis, and death in patients with blunt injury and nephrectomy for penetrating injuries. J Trauma 60:351–356PubMedCrossRefGoogle Scholar
  20. Miller LA, Shanmuganathan K (2005) Multidetector CT evaluation of abdominal trauma. Radiol Clin North Am 43:1079–1095 (viii)PubMedCrossRefGoogle Scholar
  21. Ortega SJ, Netto FS, Hamilton P, Chu P, Tien HC (2008) CT scanning for diagnosing blunt ureteral and ureteropelvic junction injuries. BMC Urol 8:3PubMedCrossRefGoogle Scholar
  22. Regine G, Stasolla A, Miele V (2007) Multidetector computed tomography of the renal arteries in vascular emergencies. Eur J Radiol 64:83–91PubMedCrossRefGoogle Scholar
  23. Santucci RA, Wessells H, Bartsch G et al (2004) Evaluation and management of renal injuries: consensus statement of the renal trauma subcommittee. BJU Int 93:937–954PubMedCrossRefGoogle Scholar
  24. Scherr MK (2009) Multi-detector computed tomography in non-traumatic urologic emergencies. Radiologe 49:516–522PubMedCrossRefGoogle Scholar
  25. Sheth S, Fishman EK (2004) Multi-detector row CT of the kidneys and urinary tract: techniques and applications in the diagnosis of benign diseases. Radiographics 24:e20PubMedCrossRefGoogle Scholar
  26. Silverman SG, Leyendecker JR, Amis ES Jr (2009) What is the current role of CT urography and MR urography in the evaluation of the urinary tract? Radiology 250:309–323PubMedCrossRefGoogle Scholar
  27. Sinelnikov AO, Abujudeh HH, Chan D, Novelline RA (2007) CT manifestations of adrenal trauma: experience with 73 cases. Emerg Radiol 13:313–318PubMedCrossRefGoogle Scholar
  28. Stuhlfaut JW, Lucey BC, Varghese JC, Soto JA (2006) Blunt abdominal trauma: utility of 5-minute delayed CT with a reduced radiation dose. Radiology 238:473–479PubMedCrossRefGoogle Scholar
  29. Titton RL, Gervais DA, Hahn PF, Harisinghani MG, Arellano RS, Mueller PR (2003) Urine leaks and urinomas: diagnosis and imaging-guided intervention. Radiographics 23:1133–1147PubMedCrossRefGoogle Scholar
  30. Urban BA, Ratner LE, Fishman EK (2001) Three-dimensional volume-rendered CT angiography of the renal arteries and veins: normal anatomy, variants, and clinical applications. Radiographics 21:373–386 (questionnaire 549-55)PubMedGoogle Scholar
  31. Van Der Molen AJ, Cowan NC, Mueller-Lisse UG, Nolte-Ernsting CC, Takahashi S, Cohan RH (2008) CT urography: definition, indications and techniques. A guideline for clinical practice. Eur Radiol 18:4–17CrossRefGoogle Scholar
  32. Vella A, Nippoldt TB, Morris JC (2001) 3rd. Adrenal hemorrhage: a 25-year experience at the Mayo Clinic. Mayo Clin Proc 76:161–168PubMedGoogle Scholar
  33. Zagoria RJ (2000) Imaging of small renal masses: a medical success story. AJR Am J Roentgenol 175:945–955PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  1. 1.Department of Clinical RadiologyLudwig-Maximilians-UniversityMunichGermany

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