Imaging of renal XXXX .

@entity1 @entity8 @entity2548 @entity130
Because of complex variables and unsettled treatment issues, a standardized prescription for imaging the acutely traumatized kidney cannot be written. Imaging considerations are based on treatment considerations and will vary from place to place, from @entity1 to @entity1 , from physician to physician, and even from time to time in the same institution. The condition of the @entity1 , the availability of resources and personnel, and (especially) whether existing treatment policy is conservative or aggressive will govern the selection of studies. Above all, since the kidney may be only one of several organs requiring immediate investigation, it is always the totality of the situation that sets the tone for the imaging process. A synthesis of prevailing thought is depicted diagrammatically in Figure 2 and is summarized as follows: CT is the most informative radiologic study in renal @entity130 and is the examination of choice in @entity1 suspected of having serious @entity8 or associated injuries amenable to CT evaluation. CT is wasteful, however, in the stable, asymptomatic @entity1 who is perceived to have only a minor, exclusively @entity8 . Here, excretory urography is an acceptable alternative. Most of these @entity1 will have normal findings at urography, all but ruling out significant @entity8 . The vast majority of @entity1 will fall into this category but for those whose urograms do not provide adequate information for management, CT is performed next. Sonography and radionuclide imaging, while advocated in some quarters, do not enjoy wide acceptance in the United States as first-line triage studies. They are usually reserved for selected situations, mainly for follow-up. Arteriography still has a place, primarily in preoperative road mapping, and for therapeutic interventions such as embolization of bleeding vessels and @entity2548 . The role of MR imaging has yet to be defined. The choice of imaging in renal @entity130 requires discretion, judgement, and common sense. Standard protocols are useful, but there is a place for flexibility and the customizing of individual approaches.
