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Erschienen in:
27.04.2018 | Classics in Abdominal Radiology
Reverse rim sign: acute renal cortical necrosis
Erschienen in: Abdominal Radiology | Ausgabe 12/2018
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The “reverse rim sign” describes the non-enhancement of the renal cortex (hypo-attenuating renal cortex) against a background of intact medullary perfusion on enhanced computed tomography, as seen in Fig. 1. It implies severe derangement of cortical vascularity with development of cortical necrosis. In some cases, there may be a thin rim of enhancing renal cortex due to collateral supply in the sub-capsular tissue, which is called as “cortical rim sign” [1]. There is no excretion of contrast on computed tomography in acute cortical necrosis. These three features are pathognomonic for acute renal cortical necrosis on enhanced computed tomography [2, 3].
Fig. 1
A axial enhanced computed tomographic rim showing the hypo-attenuating renal cortex against the backdrop of intact medullary enhancement suggesting “reverse rim sign” due to acute cortical necrosis in right kidney. The left kidney was severely hydronephrotic with papery thin cortex due to a large calculus at pelviureteric junction. B Coronal reformatted CT Image showing the “reverse rim sign” due to acute cortical necrosis in right kidney and severely hydronephrotic left kidney
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