PMC9990424_01
Magnetic resonance venography of the kidneys demonstrating marked narrowing and poor opacification of the renal veins bilaterally with perinephric venous collaterals. A: Axial T1 fat-saturated image obtained 5 minutes following contrast administration demonstrates diffuse narrowing and irregularity of the right renal vein (white arrow) and the presence of bilateral perinephric collateral veins (black arrow). B: Coronal volumetric interpolated breath-hold examination (VIBE) image obtained 6 minutes following contrast administration demonstrates narrowing and irregularity of the distal left renal vein (white arrow).
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Figure1
Magnetic resonance venography (MRV) (Figure 1) revealed markedly narrowed bilateral renal veins with poor contrast opacification.
Computed tomography angiography of the kidneys demonstrating bilateral renal vein thrombosis and perinephric venous collaterals. A: Axial contrast-enhanced image demonstrates a filling defect in the distal right renal vein (black arrow) and bilateral perinephric collateral veins. There is left-sided hydronephrosis with increased density in the left renal pelvis likely representing hemorrhage. B: Coronal contrast-enhanced image demonstrates a filling defect within the proximal left renal vein (black arrow) and bilateral perinephric collateral veins (white arrow).
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Figure2
After pre-hydration with 1 L of normal saline, the patient underwent a contrast-enhanced CT of the abdomen (Figure 2), which demonstrated filling defects in the renal veins bilaterally consistent with acute thrombus and marked attenuation of the distal left renal vein. 