Imaging Pearls ❯ Vascular ❯ Renal Vein
|
-- OR -- |
|
- Renal Vein Thrombosis: Causes
- Primary hypercoagulability disorders (e.g., antithrombin III deficiency, protein C or S deficiency, factor V Leiden mutation, prothrombin G20210A mutation)
- Antiphospholipid syndrome
- Postrenal transplant/allograft rejection
- Renal vasculitis
- Sickle cell nephropathy
- Systemic lupus erythematosus (SLE)
- Amyloidosis
- Diabetic nephropathy
- Trauma
- Renal tumors extend into the RV (RCC, TCC) - Renal Vein Thrombosis: Facts
- Renal vein thrombosis (RVT), the presence of thrombus in the major renal veins or its tributaries, is a rare clinical entity.
- Males are affected more commonly than females with no racial predilection.
- Clinical manifestations vary by the rapidity of the venous occlusion.
- The most common etiology is nephrotic syndrome, though can be seen with primary hypercoagulability disorders, malignant renal tumors, infections, trauma, or as a post-renal transplant complication.
- Renal Veins: Facts
- Left renal vein is 3x larger than the right renal vein (7.5 cm vs 2.5 cm)
- Multiple renal veins in up to 30% of patients
- Left renal vein variations include retro-aortic renal vein and circumaortic renal vein
- Left renal vein receives the left adrenal vein, left gonadal vein, and a lumbar vein - Renal Veins: Pathologies
- Renal vein thrombus
- Rein vein tumor thrombus
- Spontaneous splenorenal shunt
- Nutcracker syndrome
- Renal varix
- AV malformation - Renal Vein Thrombus: Etiologies
- Glomerulonephritis
- Collagen vascular disease
- Trauma
- Malignancy
- Dehydration (children)
- Sepsis (children) - Renal Vein Thrombus: CT Findings
- Partial or total thrombus in the renal vein
- More common in left renal vein
- Vein may be distended
- Enlarged kidney
- Delayed or persistent CT nephrogram
- Collaterals around kidney (“cobwebs”)