Hibbert J, Howlett D, Greenwood K, MacDonald L, Saunders A. MR renal venography may be performed, especially if the patient has renal impairment which does not permit the use of intravenous contrast medium 4. MRI in patients with acute renal vein thrombosis may also show loss of corticomedullary differentiation on T1-weighted spin echo images, increased signal in the affected kidney on T2-weighted images, renal fascial thickening, and renal enlargement. Gradient echo technique shows thrombus as a filling defect of intermediate signal intensity that replaces the high signal of flowing blood.Ĭoronal MRI helps determine the extent of vena caval involvement. Renal vein thrombus may be shown on T1-weighted spin echo pulse sequences when the signal void of flowing blood in the renal vein is replaced by high signal because of thrombus. In the chronic phase of renal vein thrombosis, the affected renal vein becomes attenuated because of retraction of the clotĬollateral vessels may appear around the kidney in chronic cases Stranding of the perinephric fat owing to edema and thickening of the renal fascia may occur Persistent cortical enhancement and lack of parenchymal enhancementĬalyceal opacification is often delayed, diminished, or absent in the affected kidneyĬhanges in attenuation, either focal or diffuse, may be present due to perfusion abnormalities 3 High resistance in the renal artery with elevated resistive indexĪs with venous thrombosis elsewhere, the thrombosis is observed as a filling defect during venous phase imaging following intravenous contrast Visualization of thrombus within the lumen Renal enlargement with hypoechoic cortex from edema (early phase)ĭecreasing size and increased echogenicity (late) Bland thrombus can coexist with tumor thrombus. Trauma is another potential cause of renal vein thrombosisĬomplications include pulmonary embolism, renal atrophy, and papillary necrosis. In adults, renal vein thrombosis can result from a variety of disorders, including: In children, renal vein thrombosis is the most common vascular condition in the neonatal kidney 1ĭehydration and sepsis are common underlying factors for renal vein thrombosis
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