Acute tubular necrosis

Case contributed by Dr David Cuete

Presentation

Patient who had undergone a contrast-enhanced CT, followed by CT three days before, followed by CT angiography to rule out pulmonary embolism 24 hrs earlier. Serum creatinine values increased from a baseline of 0.9 to 3.4 at the time of this CT exam.

Patient Data

Age: 70 years
Gender: Female
CT

Abdominal unenhanced CT

Persistent bilateral kidney enhancement, containing multiple areas of high density striations of the renal parenchyma. Notice the lack of contrast in the vascular space. Minimal delayed excretion is seen as evidence of decreased renal function.

It is also possible to see a large metastasis for which the contrast study was requested.

Case Discussion

The striated nephrogram in this case depicts contrast material trapped in necrosed renal tubules. This represents the consequences of contrast-induced nephropathy.

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