Renal hemangioma is an uncommon benign tumor which usually causes painless or painful gross hematuria. Its preoperative diagnosis is extremely difficult or even impossible. We experienced three cases of renal hemangioma, located mainly at the pelvocalyceal junction or in the inner medulla. US demonstrated variable echogenecity, and CT revealed a lack of significant enhancement. Where there is gross hematuria in a young adult, especially when the renal mass located in the pelvocalyceal junction or inner medulla shows little enhancement on CT, renal heman-gioma should form part of the differential diagnosis.
Adult ; Case Report ; Diagnosis, Differential ; Hemangioma, Capillary/*radiography/*ultrasonography ; Hemangioma, Cavernous/*radiography/*ultrasonography ; Hematuria/etiology ; Human ; Kidney Neoplasms/*radiography/*ultrasonography ; Male ; Tomography, X-Ray Computed

This review article comprehensively discusses multidetector CT urography protocols and their role in imaging of the urinary tract in patients with hematuria.
Hematuria/etiology/*radiography ; Human ; Incidental Findings ; Sensitivity and Specificity ; Tomography, X-Ray Computed/*methods/standards ; Urinary Tract/abnormalities ; Urography/methods/standards ; Urologic Diseases/complications/congenital/radiography

OBJECTIVE: To evaluate the frequency and relevance of the "sentinel clot" sign on CT for patients with traumatic intraperitoneal bladder rupture in a retrospective study. MATERIALS AND METHODS: During a recent 42-month period, 74 consecutive trauma patients (45 men, 29 women; age range, 12-84 years; mean age, 50.8 years) with gross hematuria were examined by the use of intravenous contrast-enhanced CT of the abdomen and pelvis, followed by retrograde cystography. Contrast-enhanced CT scanning was performed by using a helical CT scanner. CT images were retrospectively reviewed in consensus by two radiologists. The CT findings including the sentinel clot sign, pelvic fracture, traumatic injury to other abdominal viscera, and the degree of intraperitoneal free fluid were assessed and statistically analyzed using the two-tailed x2 test. RESULTS: Twenty of the 74 patients had intraperitoneal bladder rupture. The sentinel clot sign was seen for 16 patients (80%) with intraperitoneal bladder rupture and for four patients (7%) without intraperitoneal bladder rupture (p < 0.001). Pelvic fracture was noted in five patients (25%) with intraperitoneal bladder rupture and in 39 patients (72%) without intraperitoneal bladder rupture (p < 0.001). Intraperitoneal free fluid was found in all patients (100%) with intraperitoneal bladder rupture, irrespective of an associated intraabdominal visceral injury, whereas 19 (35%) of the 54 patients without intraperitoneal bladder rupture had intraperitoneal free fluid (p < 0.001). CONCLUSION: Detection and localization of the sentinel clot sign abutting on the bladder dome may improve the accuracy of CT in the diagnosis of traumatic intraperitoneal bladder rupture, especially when the patients present with gross hematuria.
Abdominal Injuries/diagnosis/etiology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Contrast Media/administration & dosage ; Extravasation of Diagnostic and Therapeutic Materials/diagnosis/etiology ; Female ; Fractures, Bone/diagnosis/etiology ; Hematuria/etiology ; Humans ; Image Processing, Computer-Assisted ; Iohexol/diagnostic use ; Male ; Middle Aged ; Observer Variation ; Pelvic Bones/injuries/radiography ; Predictive Value of Tests ; Radiographic Image Enhancement/methods ; Reproducibility of Results ; Retrospective Studies ; Rupture/diagnosis ; Tomography, Spiral Computed/*methods ; Urinary Bladder/*injuries/*radiography ; Wounds, Nonpenetrating/complications/*diagnosis