Cortical rim sign (kidneys)
Updates to Article Attributes
The cortical rim sign is useful in distinguishing lobar nephronia from a segmental renal infarct and is seen on contrast enhanced CT or MRI.
The wedges of reduced enhancement seen in the setting of acute pyelonephritis represent oedema and ischaemia which involves the whole wedge or renal parenchyma, from medulla to the capsule. This sign seen as a result of cortical necrosis may also be seen in conditions like renal transplant rejection, intravascular haemolysis, shock, and as a consequence of obstetric complication.3
In segmental infarcts, the later blood supply to the very outer aspect of the cortex is derived from perforating branches of the renal capsular artery which is an early branch of the renal artery. As such, when a branch of the renal artery is occluded (by thromboembolism, dissection etc..) perfusion is preserved to a thin rim (2-4mm-4 mm) of cortex which enhances normally.
Unfortunately the cortical rim sign is only seen in approximately half of renal infarcts.
See also
-<p>The <strong>cortical rim sign</strong> is useful in distinguishing <a href="/articles/lobar-nephronia" title="lobar nephronia">lobar nephronia</a> from a segmental <a href="/articles/renal-infarct" title="renal infarct">renal infarct</a> and is seen on contrast enhanced CT or MRI. </p><p>The wedges of reduced enhancement seen in the setting of <a href="/articles/acute-bacterial-pyelonephritis" title="Acute pyelonephritis">acute pyelonephritis</a> represent oedema and ischaemia which involves the whole wedge or renal parenchyma, from medulla to the capsule. This sign seen as a result of <strong>cortical necrosis </strong>may also be seen in conditions like renal transplant rejection, intravascular haemolysis, shock, and as a consequence of obstetric complication.<sup>3</sup></p><p>In segmental infarcts, the later blood supply to the very outer aspect of the cortex is derived from perforating branches of the <a href="/articles/renal-capsular-artery" title="renal capsular artery">renal capsular artery</a> which is an early branch of the <a href="/articles/renal-artery" title="renal artery">renal artery</a>. As such, when a branch of the renal artery is occluded (by thromboembolism, <a href="/articles/arterial-dissection" title="Arterial dissection">dissection</a> etc..) perfusion is preserved to a thin rim (2-4mm) of cortex which enhances normally. </p><p>Unfortunately the cortical rim sign is only seen in approximately half of renal infarcts. </p><h4>See also</h4><p></p><ul><li><a href="/articles/rim-sign-in-renal-vascular-compromise" title="Rim sign in renal vascular compromise">rim sign in renal vascular compromise</a></li></ul>- +<p>The <strong>cortical rim sign</strong> is useful in distinguishing <a href="/articles/lobar-nephronia">lobar nephronia</a> from a segmental <a href="/articles/renal-infarct">renal infarct</a> and is seen on contrast enhanced CT or MRI.</p><p>The wedges of reduced enhancement seen in the setting of <a href="/articles/acute-bacterial-pyelonephritis">acute pyelonephritis</a> represent oedema and ischaemia which involves the whole wedge or renal parenchyma, from medulla to the capsule. This sign seen as a result of <strong>cortical necrosis </strong>may also be seen in conditions like renal transplant rejection, intravascular haemolysis, shock, and as a consequence of obstetric complication.<sup>3</sup></p><p>In segmental infarcts, the later blood supply to the very outer aspect of the cortex is derived from perforating branches of the <a href="/articles/renal-capsular-artery">renal capsular artery</a> which is an early branch of the <a href="/articles/renal-artery">renal artery</a>. As such, when a branch of the renal artery is occluded (by thromboembolism, <a href="/articles/arterial-dissection">dissection</a> etc..) perfusion is preserved to a thin rim (2-4 mm) of cortex which enhances normally.</p><p>Unfortunately the cortical rim sign is only seen in approximately half of renal infarcts.</p><h4>See also</h4><ul><li><a href="/articles/rim-sign-in-renal-vascular-compromise">rim sign in renal vascular compromise</a></li></ul>
Image 1 Annotated image ( update )
Image 4 CT (C+ portal venous phase) ( update )
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