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Volume 54, Issue 5 , Pages A37-A39 , November 2009

Quiz Page November 2009: Refractory Hypertension in a Man Undergoing Long-term Hemodialysis

Color Doppler ultrasound of the left kidney.

Color Doppler ultrasound of the left kidney.
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Contrast-enhanced abdominal computed tomography.

Contrast-enhanced abdominal computed tomography.
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Oblique coronal maximum intensity projection computed tomographic angiography showed dilated vessels (large arrow) with early opacification of the renal vein (small arrow) in the left kidney.

Oblique coronal maximum intensity projection computed tomographic angiography showed dilated vessels (large arrow) with early opacification of the renal vein (small arrow) in the left kidney.
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Selective left renal digital subtraction angiography shows localized tortuous vascular channels (large arrow) in the lower pole of the left kidney with early filling of the left renal vein (small arro

Selective left renal digital subtraction angiography shows localized tortuous vascular channels (large arrow) in the lower pole of the left kidney with early filling of the left renal vein (small arrow) on the arterial phase.
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Case provided and authored by Yi-Chun Chen, MD,^1,2 Yu-Chieh Su, MD,^2,3 Chih-Wen Lin, MD,⁴ and Shang-Jyh Hwang, MD,⁵ ¹Division of Nephrology, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi; ²School of Medicine, Tzu Chi University, Hualien; ³Division of Hematology-Oncology and ⁴Department of Medical Imaging, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi; and ⁵Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.Address correspondence to Chih-Wen Lin, MD, Department of Medical Imaging, Buddhist Dalin Tzu Chi General Hospital, No. 2, Minsheng Rd, Dalin Township, Chiayi County 622, Taiwan. E-mail: dalinchiayi@yahoo.com.tw