الفهرس 
Anatomy of the KidneysOnly 14 pages are availabe for public view
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Abstract
Renal trauma is the most common urologic trauma and occurs in 8-10% of patients with significant blunt or penetrating abdominal trauma. In most cases, major renal injuries are associated with injuries to other major organs.
The goal in trauma care is to resuscitate the patient, to diagnose injuries, and to implement appropriate therapeutic measures. Efficient organization of trauma centers with optimal resuscitation techniques and early imaging leading to accurate grading are needed to determine appropriate clinical management. Radiologists serve an integral role in the multidisciplinary approach to achieve that goal, playing a large part in the diagnosis and grading of injuries.
Renal injuries are graded by the American Association for the Surgery of Trauma (AAST) on the basis of the depth of injury and the involvement of vessels or the collecting system as follow:
Grade 1 represents hematuria with normal imaging studies, contusions and nonexpanding subcapsular hematomas
Grade 2 represents nonexpanding perinephric hematomas confined to the retroperitoneum and superficial cortical lacerations less than 1 cm in depth without collecting system injury.
Grade 3 represents renal lacerations greater than 1 cm in depth that do not involve the collecting system.
Grade 4 represent renal lacerations extending through the kidney into the collecting system, injuries involving the main renal artery or vein with contained hemorrhage , segmental infarctions without associated lacerations and expanding subcapsular hematomas compressing the kidney
Grade 5 the most sever grade which represent shattered or devascularized kidney, ureteropelvic avulsions and complete laceration or thrombus of the main renal artery or vein.
The above grading system has become apart of language for imaging evaluation which is used by trauma surgeon.
There are several imaging modalities contribute in diagnosis of renal trauma such as ultrasonography, intra venous urography, angiography, retrograde pyelography, renal scintigraphy, magnetic resonance imaging (MRI) and multidetector computer tomograghy (MDCT).
MDCT is the most recent advance in CT technology. It uses a multiple row detector array.
These new CT scanners, with reduced gantry rotation times (0.5 s or less for one 360-rotation), allow 2 to 25 times faster scan times than helical CT with the same or better image quality.
MDCT allows images to be obtained in diffrent phases of renal parenchyma enhancement and excretion in the collecting system after administration of a single bolus of intravenous contrast material.Therefore, demonstration of the collecting system abnormalities.
The main advantages of MDCT are faster scanning time, increased volume coverage, and improved spatial and temporal resolution.
MDCT is the technique of choice for evaluating renal trauma. MDCT in particular can give accurate information about the status of the renal parenchyma, blood vessels, and collecting system because this technique can cover a target organ in a shorter time and with a thinner section slice than conventional CT.