الفهرس 
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Abstract
The current study aims to measure the current practice of MDCT in determine grades of renal injury .
This study was conducted in Assuit University Hospital Trauma Unit and radiology department during the period from april 2017 to March 2018 .
MDCT is now one of the most reliable and effective methods in determine grades of renal injury , with the advantage of being extremely fast and minimally invasive.
Recent improvements in MDCT technology confer the highest value of diagnostic accuracy with respect to other imaging modalities.
Contrast Enhanced CT is a non-invasive method allowing proper visualization of renal arterial ,venous anatomy and enhanced parenchyma.
The ability to cover substantial anatomic volumes with high in-plane and through-plane spatial resolution has brought a number of clear advantages.
The near isotropic nature of high-spatial-resolution multi– detector row CT data lends itself to two- and three-dimensional visualization.
It’s audit study carried out in radiology department and Assuit University Hospital Trauma Unit .our study included 61 patients.
As regard mechanism of trauma our study have 55 (90.2%) patients with blunt renal trauma and 6 (9.8%) patients with penetrating renal trauma.
The study had 9 patients with grade 1, 2 patients with grade II , 12 patients with grade III , 25 patients with grade IV and 13 patients with grade V .
Our study had 37 patients presented with hematuria and 24 patients presented with clear urine at the time of trauma; hematuria was not related to the degree or mechanism of trauma.
In our study conservative management was successful in 72.1% of cases while only 27.9% of patients had interventional management with high rate of nephrectomy in 19.7% of patients.
The cause of intervention in our study shows no statistical significant between grade of trauma and rate of intervention the main predictor of intervention was hematuria and hemodynamic instability.
Different methods of intervention in our study included 12 patients who underwent nephrectomy, 3 patients underwent renorrhaphy, 1 patients underwent angioembolization for development of secondary hemorrhage, 1patients underwent DJ insertion.
According to results of cases found Nonoperative management of renal trauma is successful in most hemodynamically stable patients, regardless of injury grade, Surgical intervention is necessary in only 27.9% of cases, of which the frequency of nephrectomy is 19.7 %, renal injuries are incidental to multiple organ trauma; therefore, it is necessary to be treated in specialized health center, The surgical
team must perform immediate intervention (surgery or angioembolization in selected situations) in hemodynamically unstable patients with no or transient response to resuscitation, the use of CT scan in combination with strict observation of conservative treatment protocols and intravascular techniques results in effective treatment of renal trauma, The right renal trauma classification according to AAST scale.