Medical Radiology - Lazar A.P. 2008

Radiation examination of the genitourinary system
Traumatic injuries of the urinary system

Injuries to the Urinary System may result in capsule rupture with retroperitoneal Hemorrhage, subcapsular hematoma, tears of the renal calyces, renal pelvis, Ureter, and Urinary Bladder. On plain abdominal radiography, retroperitoneal hemorrhage is indicated by the loss of Definition of the lateral border of the psoas Muscle on the affected side. On sonography, a fresh hematoma appears as an echonegative, homogeneous mass with well-defined margins, whereas it becomes heterogeneous following Blood clot formation. On CT, the densitometric density of a fresh hematoma reaches +50 HU. Traumatic rupture of the renal parenchyma is accompanied by urinary extravasation into the rupture site, forming a slit-like area of decreased density ranging from +10 to +20 HU, which resembles a cone with its apex pointing toward the renal hilum (Fig. 254). On MRI, a hematoma differs from the renal parenchyma in signal intensity, which varies as the hematoma evolves and organizes. During retrograde pyelography, if the renal pelvis or calyces are ruptured, the contrast medium extravasates into the renal parenchyma, whereas in tears of the Ureters and bladder wall, the contrast medium extends beyond their boundaries.

Class="center">

Fig. 254. Intrarenal hematoma (arrow) of the right Kidney on a computed tomography scan.



Last update: 08/08/2026

Editorial and Educational Adaptation: This material has been compiled based on the primary/original source text. The project team performed an editorial review, corrected technical inaccuracies, structured sections, and adapted the content for an educational format.

What was processed:

  • elimination of formatting defects (OCR errors, structural breaks, corrupted characters);
  • editorial organization of content;
  • standardization of terminology in accordance with academic sources;
  • verification of factual statements against the original source text.

All mentions of the author, publication year, and origin of the primary text have been preserved in accordance with the source.