The clinical assessment suggested that there was a high possibility of a renal abnormality. Figure 3 Figure 4 Similarly, the patient with hepatic infarction after transplantation and mesenteric venous thrombosis shown in figures 3 and 4 would not have been diagnosed properly without IV contrast. The concept of using CT to evaluate patients with acute abdomen began through the renal colic protocol. Anatomic information is sufficient to manage the patient. It is considerably faster to perform, it requires no contrast, it is more accurate for small calculi, it can suggest other diagnoses, and it is cost-competitive.
Many urologists have a hard time giving up IVPs.
Often when evaluating the kidney, they have a strong attachment to plain films. 7 One of the findings the radiologist should emphasize to residents is forniceal rupture. The residents should be encouraged to look at the fluid that transudates from forniceal rupture as it layers along the fibrous lamellae of the perinephric space. The spoke-wheel pattern in figure 6 is typical of forniceal rupture. Figure 8 Figure 8 shows the CT technique for renal colic.