PMC4897979_01
27-year-old woman with acute renal infarction. (A-D) CT scan with contrast shows multiple perfusion defects in the lower pole of the left kidney.
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The CT scan showed perfusion defects in the lower pole of the left kidney (Fig. 1), leading to a strong suspicion for renal infarction, or less likely a renal infection.
27-year-old woman with acute renal infarction. (A) Coronal MRI shows perfusion defects in the lower pole of the left kidney. (B) Sonogram shows normal left kidney. (C) Doppler shows no renovascular abnormality.
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An MRI/MR angiogram was then obtained which again showed perfusion defects in the lower pole of the left kidney; sonography with Doppler showed no renovascular abnormality (Fig. 2).
27-year-old woman with acute renal infarction. (A-B) MRI shows a cortical rim sign (arrow) in the left kidney.
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CT and MRI, but much better appreciated on MR images (Fig. 3). Concomitantly, an embolic workup was performed with a negative Doppler ultrasound of the lower extremities and a normal transthoracic echocardiogram.
27-year-old woman with acute renal infarction. (A-B) Angiogram shows ovoid filling defect (arrow) in a segmental branch of the left renal artery in the lower pole, consistent with thrombus.
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At angiography, an ovoid filling defect was found in a segmental branch of the left renal artery in the lower pole, consistent with thrombus (Fig. 4).
27-year-old woman with acute renal infarction. (A-B) Transesophageal echocardiogram shows a small patent foramen ovale with bidirectional shunting.
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When thrombus was confirmed, a transesophageal echocardiogram was performed which showed a small patent foramen ovale with bidirectional shunting (Fig. 5).