 Good morning all. I'm Dr. Alina Ali Thadir, postgraduate from Osmania Medical College, Hyderabad. I'm hereby presenting my paper on Projectional Imaging in Blunt Renal Trauma, a prospective study. This study was done under the guidance of Dr. Nadi Muhammad and Dr. Vijay Kumari, professors of Osmania Medical College, Hyderabad. Renal injury is the third most common solid organ injury in blunt abdominal trauma accounting for 14.1 cases of abdominal injuries in which blunt trauma accounts for up to 70%. CT is the method of choice for blunt renal injuries. Contrast enhanced CT is readily available in emergency department and can quickly and accurately depict renal injuries as well as associated injuries to other abdominal or retropyrtonal organs. The AST grading system is a widely used classification based on surgical findings and shows good correlation both with CT findings and prognosis. Ames and objectives to show wide spectrum of computer tomography findings in blunt renal trauma describe and illustrate imaging features of range of AST injury grades of renal trauma. Materials and methods. Study design and place of study, hospital based observational prospective study conducted in department of radio diagnosis at the tertiary care hospital. Study period 24 months starting from October 2019. Study subjects patient with history of blunt abdominal trauma referred for CECT abdomen. Patient with CECT features of renal injury included in the study and unstable patients, patients with other solid organ injuries, bowel injuries, miscentric injuries and patients of age less than 18 years, patient with history of penetrating trauma where excluded from the study. Patients suspected of having blunt abdominal trauma coming to emergency department undergo ultrasound abdomen followed by contrast enhanced CT. The CT was performed in 128 slice multi-dictator CT Hittachi scenario. After ingestion of non-ionic contrast omnipig 300 ml per kilogram at 3 ml per seconds, CT acquisition performed in late arterial phase and in the portal venous phase. Delayed scanning done in case of higher grade of injury. A total of 93 patients were evaluated in which 20 patients showed CECT features of renal injury. The injury study was reviewed for identification of renal injuries and injuries were graded according to 2018 ASD renal injury scale. A statistical analysis was performed with frequency and percentages variables, observation. After 20 patients with renal injuries, majority of our male according for 85 person and three females and 70 males were enrolled in the study of age ranging from 20 to 60 years. Majority of the patients of age 30 to 40 years. Eight patients are grade 1 injury of which CECT showed renal condition of subcapsular hematoma. Four patients had grade 2 injury of which renal laceration of less than 10 mm detected in CT. Three patients had grade 3 injury with CECT showed laceration of more than 10 mm. Three patients showed grade 4 injury of which two patients showed paranchymal laceration extended into renal hyalum with urinary extravasation in delayed scan. One patient with grade 4 injury showed D-paramic amylaceration extending into renal pelvis causing segmental infarction of the kidney. Two patients had grade 5 injury with CECT features of complete devascularization of the kidney. 70 patients had associated hemoperitoneum. Three patients had splenic injury and six patients had liver injury and three patients had associated fractures like pelvic fractures, vertebral fractures and refractures. Majority of the injuries were of grade 1 according for 40% of the cases. These are some representative images from my study. First image, 30-year-old male patient with a history of rotographic accident. Axial, condors and hand CT showing hypodensity in order involving upper pole. Second case, 35-year-old male patient with a history of fall. Axial, condors and hand CT showing subcapsular hematoma. These are grade 1 injuries. Next case is 33-year-old female patient with a history of rotographic accident. Axial, condors and hand CT showing laceration of less than 10 mm with the perirenal hematoma. This is a case of grade 2 injury. Next case is 40-year-old male patient with a history of rotographic accident. Axial, condors and hand CT showing laceration extending into the renal into the collecting system. This is a case of grade 3 injury. Next case is 28-year-old male patient with a history of RTA. Axial, condors and hand CT showing hematoma extending beyond the gerota fascia. On delayed scanning, urinary extroversation was not done. This case is a coronal, condors and hand CT showing hypodensity involving mid and lower pole of kidney, suggesting segmental these two are cases of grade 4 injury. Next case is 40-year-old male patient with a history of RTA. Coronal, condors and hand CT showing complete devasculation of the left kidney, suggesting grade 5 injury. Renal injuries are classified into 5 grades of severity according to the American Association of Surgeons in Trauma Injury Severeity Scale. Grade 1 is subcapsular hematoma and or parangamel condition without laceration. Grade 2 is perirenal hematoma confined to gerota fascia. Renal parangamel laceration less than or equal to 1 centimeter depth without urinary extroversation. Grade 3 is renal parangamel laceration more than 1 centimeter depth without collecting system rupture or urinary extroversation. Any injury in the presence of kidney vascular injury would active bleeding contained within the gerota fascia also included. Grade 4 is parangamel laceration extending into urinary collecting system with urinary extroversation. Renal pelvis recombinant or retropel with disruption. Segmental renal vein or artery injury. Active bleeding beyond gerota fascia into the retropyrtonium or peritonium. Segmental or complete kidney infarction due to vessel thrombosis with active bleeding. Grade 5 is main renal artery or vein laceration or avulsion of hyalum. Devasculase kidney with active bleeding. Shattered kidney with loss of identified parangamel renal anatomy. All cases in the study with one blunt renal injuries are classified based on American association of surgery of trauma. This classification enable standardization of various renal trauma and the choice of proper therapy and prediction. Majority of renal injuries detected were minor injuries like condition minor parangamel laceration which were amenable to non-operative management. Deep parangamel laceration on urinary extroversation can also be treated conservatively. A delay scan can be used in patient with renal damage. Degree to determine whether the color system is damaged or not. In our study damage to renal pelvis were noted in three patients. Conclusion. MDCT can generate wide spectrum of findings in renal trauma. Majority of these can be easily categorized into five AST grades. The AST classification must be kept in mind when reporting renal injuries. We concluded that enhanced MDCT scan permits reliable detection of renal trauma and the associated organ or tissue injuries. Providing important clinical value for the diagnosis and classification of renal trauma or internal organ injuries. These are my references. Thank you.