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lüll CT evaluation of renovascular disease Kawashima A; Sandler CM; Ernst RD; Tamm EP; Goldman SM; Fishman EKRadiographics 2000[Sep]; 20 (5): 1321-40Computed tomography (CT) plays an important role in evaluation and management of primary renovascular disease. Nonenhanced CT is useful for demonstrating renal hemorrhage, renal parenchymal or vascular calcifications, and masses. Contrast material-enhanced CT is essential to identify global or regional nephrographic abnormalities resulting from the vascular process (eg, renal infarcts, ischemia secondary to renal artery stenosis, arteriovenous communications). In addition, renal manifestations of a systemic disease (eg, vasculitis, thromboembolic disease) can be seen at CT. In trauma, occlusion of the main renal artery can be accurately diagnosed with contrast-enhanced CT. In cases of spontaneous renal hemorrhage without an apparent cause (eg, vasculitis, coagulopathy), a careful CT study should be performed to exclude renal cell carcinoma. The presence of fat in a hemorrhagic renal mass larger than 4 cm in diameter is characteristic of angiomyolipoma complicated by hemorrhage. Acute renal vein thrombosis appears as a clot in a distended renal vein, whereas renal vein retraction with collateral vessels is highly indicative of chronic thrombosis. Helical CT, especially with multiplanar two-dimensional and three-dimensional reconstruction following an intravenous injection of iodinated contrast material, has greatly improved our ability to directly image the proximal renal arteries and detect vascular lesions.|*Tomography, X-Ray Computed[MESH]|Diagnosis, Differential[MESH]|Humans[MESH]|Ischemia/diagnostic imaging[MESH]|Kidney Diseases/*diagnostic imaging[MESH]|Kidney Neoplasms/diagnostic imaging[MESH]|Kidney/*blood supply/diagnostic imaging[MESH]|Renal Artery Obstruction/diagnostic imaging[MESH]|Vasculitis/diagnostic imaging[MESH] |