腎皮質壊死の1例―病態生理と画像所見の考察

A case of renal cortical necrosis secondary to postpartum massive bleeding with severe preeclampsia

腎皮質壊死は，腎皮質に限局して虚血性の壊死性病変をきたす疾患であり，周産期の発症が全体の50％程度と多い。今回，産後大量出血に続発した腎皮質壊死のダイナミックCTにおける画像所見が得られたので，文献的考察とともに報告する。

CT showed a poor contrast effect of the cortex of the kidney and a strong contrast effect of the medulla in the arterial phase, which has not been reported. In this case, all the three factors of Virchow’s triad were present：vascular endothelial damage due to hypertensive disorders of pregnancy, hypercoagulability caused by obstetrical DIC, and decreased renal blood flow. This background and the specific renal hemodynamics that occur during decreased renal blood flow caused cortical necrosis.