Name That Nephrogram: Asymmetric Renal Enhancement in the Acute Care Setting

Disorders of the kidney and urinary collecting system are common encountered in the acute care setting. Computed tomography has progressively replaced intravenous pyelography for the evaluation of most urinary tract pathology including acute flank pain, suspected malignancy, congenital abnormalities, anatomical variants, and inflammatory/vascular conditions through evaluation of the “nephrogram” produced by intravenous contrast material filtering through the kidneys. In this review, we describe the most common types of abnormal nephrograms seen on renal computed tomography, and highlight the salient features and conditions associated with them, in addition to a pictorial review with specific and interesting related cases. The types of abnormal nephrograms reviewed are absent, unilateral delayed, striated, spotted, and persistent.