Wedge-Shaped Patchy Renal Ischemia
Contrast medium is filtered from glomeruli and excreted by the kidney. Owing to the differences in kidney function in local areas, a patchy lesion is visualized, not a diffuse lesion. We performed dynamic computed tomography (CT) in order to examine changes in the early phase after the administration of contrast medium (cortical phase, after 20–30 s). In areas with severe renal ischemia, contrast enhancement was less marked, and there was minimal cortical enhancement (the uptake of contrast medium was low at 3 min). However, in areas with mild renal ischemia, stronger contrast enhancement was observed. Delayed CT of a few hours and 1–2 days after the administration of contrast medium showed gradual wedge-shaped contrast enhancement in areas with severe renal ischemia (Fig. 12). However, in areas with mild renal ischemia, contrast medium had been excreted, and there was no contrast enhancement. The sites of contrast enhancement on CT were reversed a few hours and 1–2 days after the administration of contrast medium compared with those 3 min after administration  (Fig. 12). Wedge-shaped contrast enhancement was clearly observed on delayed CT 3 h and 1–2 days after the administration of contrast medium.
KeywordsContrast Medium Acute Renal Failure Contrast Enhancement Renal Ischemia Dynamic Compute Tomography
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