Objective To discuss the imaging diagnostic features of adrenal injury. Methods The imaging features of the 29 patients of adrenal bruise and hernatoma (20 male and 9 females, average age 37) were retrospectively analyzed. The clinical appearances were all flank and hack pain, local sensitive to percus-sion and associated injury appearance. Among the 29 cases, 25 cases(86%) had adrenal injuries on right side, 2 cases(7%) on left side, and 2 cases(7%) on both sides, and no apparent abnormality was found in the relevant endocrine examination after injury. CT (n=29), MRI (n=5) and ultrasonography (n=6) were checked. CT follow-up were taken in 23 eases. MRI (n=1) and ultrasonography (n=l) were followed as well. Results The first-time exam coincidences of CT, MRI and sonography were 28/29 (97%), 5/5 (100%) and 3/6 (50%) respectively. One case of simple right-side adrenal hematoma 3 weeks after injury wasn't clearly diagnosed by CT, which was later diagnosed by MRI. The CT features of adrenal bruise were local or diffuse intumescence and focus high-density hemorrhage shadow. The CT appearances of acute stage adrenal hematoma were round-like high-density shadow without enhancement and the diameters were 1-3 cm. MRI appearances of 5 cases of subacute and chronic phase hematoma were typical high signal of T1WI, T2WI and DWI and toroid low signal around T2WI. Hematorna was not be enhanced when CT or MRI en-hancement scanning, and formed characteristic "nut-like" image feature with toroid high-density or high sig-nal enhanced shadow forming around. Uhrasonography appearances of 3 cases of hematoma were abnormal shadow of the adrenal gland. Conclusions CT is the prior imaging method for adrenal bruise and hemato-ma. MRI has the characteristic appearance for the few cases which are difficult to be identified by CT and ul-trasonography. Characteristic "nut-like" image feature is helpful for the diagnosis and differential diagnosis.

Objective To evaluate the clinical diagnosis and treatment of acute renal infarction.Methods Two cases (3 sides) of acute renal infarction were reported.The patients were 1 male and 1 female,with the age of 62 and 54 years.Case 1 presented acute left flank pain,and enhanced CT showed a non-enhanced area in the upper and mid pole of the left kidney.The diagnosis of focal renal infarction was made and treated with low-molecular heparin (6000 U ).Case 2 presented acute both right abdominal and flank pain,and enhanced CT showed right renal artery embolism and right renal complete infarction.Digital subtraction angiography (DSA) and catheter thrombolytic therapy was applied.4 months later,the patient presented acute left flank pain,and enhanced CT showed a low density area in left kidney without enhanced by contrast,and DSA and catheter thrombolytic therapy was applied again.Results In case 1,contrastenhanced MRI showed a still low signal area like enhanced CT after 2 days of treatment.The renal function remained normal in the follow-up of 36 months.In case 2,the right kidney resorted to moderate blood flow but became atrophy later.In the follow-up of 4 months,a recurrent focal infarction was confirmed in left kidney by enhanced CT.The left kidney also resorted to moderate bloodflow after DSA and catheter thrombolytic therapy.The renal function became normal after follow-up of 10 months and no new infarction was observed.Conclusions The diagnosis of acute renal infraction could be made by enhanced CT or MRI.Early diagnosis and location of the infraction renal artery is critical for recovery of the impaired renal function.Acute renal infraction should be suspected in patients with unexplained persistent and steady flank or abdominal pain in emergence department.