MP25-01 CT VOLUMETRIC MEASUREMENTS ESTIMATE FUTURE SPLIT RENAL FUNCTION IN RENAL TRAUMA PATIENTS WITH SEGMENTAL VASCULAR INJURIES

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: External Genitalia Reconstruction and Urotrauma (including transgender surgery) II1 Apr 2018MP25-01 CT VOLUMETRIC MEASUREMENTS ESTIMATE FUTURE SPLIT RENAL FUNCTION IN RENAL TRAUMA PATIENTS WITH SEGMENTAL VASCULAR INJURIES Paul H Chung, Joel A Gross, and Judith C Hagedorn Paul H ChungPaul H Chung More articles by this author , Joel A GrossJoel A Gross More articles by this author , and Judith C HagedornJudith C Hagedorn More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.838AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patients involved in renal trauma may experience loss of renal function. Nuclear medicine (NM) renal scans may be obtained after the initial recovery process to assess split renal function; however, this involves additional radiation, financial, and manpower burden. We hypothesized that volumetric measurements based on computer tomography (CT) imaging obtained during the initial trauma survey may be used to estimate future split renal function. METHODS A retrospective review was performed of renal trauma patients treated at a Level 1 trauma center between 2008 to 2015. Only patients with unilateral, segmental vascular injuries (SVI) on initial CT who obtained follow up NM mercaptoacetyltriglycine (MAG3) renal imaging were included. No patient had coexisting renal disease such as renal mass, stone disease, or congenital malformations. CT images were exported to syngo.via software (Siemens Medical Solution, Malvern, PA). A radiologist with a focus in urological trauma manually traced injured and total kidney parenchyma, and the software was used to render volumes and three-dimensional images. CT based split renal function was calculated by assessing the ratio of ipsilateral uninjured kidney volume to bilateral total uninjured kidney volume. RESULTS Eight patients with unilateral, SVI on initial trauma CT imaging were identified. Seven patients were male and mean age was 28 years (range 14-48). Six patients had right-sided injuries. All injuries were secondary to blunt trauma (4 motor vehicle collisions, 3 falls, and 1 crush injury). No patient required surgical renal exploration. Patients underwent NM MAG3 renal imaging at a mean of 4 months (range 2-6). Mean split renal function of the injured kidney was 43% (range 22-57). Based on CT volumetric measurements of the injured kidney, mean percent injured was 23% (range 5-60) and calculated split renal function was 44% (range 23-58). Calculated CT split function directly correlated with NM split function (R=0.98). The time required to calculate volume of a kidney was 13 minutes (range 10-15) and volume of a SVI was 5 minutes (range 3-6). CONCLUSIONS Volumetric measurements based on CT imaging from the initial trauma evaluation is a viable method to estimate future split renal function. This method avoids the additional radiation, financial, and manpower burden of a NM renal scan. Further evaluation of CT volumetric imaging is required to assess feasibility with more complex and multifocal injuries. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e326 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Paul H Chung More articles by this author Joel A Gross More articles by this author Judith C Hagedorn More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...