Renal cortical retention of contrast medium on delayed CT and nephropathy following transcatheter arterial chemoembolisation in patients with high serum creatinine level

Abstract

The aim of this study was to investigate the prevalence of renal cortical retention (RCR) of contrast media seen on delayed CT, and nephropathy following transarterial chemoembolisation (TACE) in high-risk patients. The findings of 18 patients with abnormally high serum creatinine levels who underwent TACE were reviewed. Nephropathy was defined as an increase in serum creatinine level of more than 44 micromol l(-1), or more than 25%, on day 1, 3, 7 or 14. RCR was defined as mild (CT value >50) or severe (CT value >100). RCR was seen in 16 cases (89%) and in seven cases (39%) of post-TACE nephropathy. Patients without severe RCR did not develop nephropathy post-TACE, whereas 50% of those with such retention did (p=0.19). Delayed CT appears to have the potential as an early detector of nephropathy post-TACE in high-risk patients.

Case of the Month #170: The Unilateral Persistent Nephrogram after Endovascular Aortic Aneurysm Repair (EVAR): New Life in an Old Sign

“…In the medical literature, most references to persistent nephrograms are related to contrast nephropathy; however, many associations were identified, including rhabdomyolysis and obstructing renal mass [1,2]. Although the physiologic basis of renal cortical retention of contrast material has not been discovered, it is thought to be a function of renal hypoperfusion and cellular injury [3]. When related to a systemic process such as hypotension, the persistent nephrogram will be bilateral, whereas a unilateral nephrogram will occur when the vascular supply of 1 kidney is compromised, as in obstruction.…”