Normal renal enhancement

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  • Arterial Phase - (30s)
  • Corticomedullary Phase - (40s) maximized corticomedullary differentiation
  • Portal Venous Phase - (60s)
  • Nephrogenic Phase - (100s), homogeneous appearance, contrast is exiting the cortical vasculature, filtered in the glomeruli and enters the Loop of Henle and collecting tubules
  • Delayed or Excretory Phase - (5 min)

Differential of Delayed Nephrogram

  • Think "blood in", "blood out", "urine out"
  • Renal artery stenosis
  • Ureteral obstruction
  • Renal vein thrombosis
  • Acute tubular necrosis
  • Contrast induced nephropathy