Abstract
BACKGROUND: Congenital renal arteriovenous fistula (RAVF) is a clinically rare condition and frequently missed and misdiagnosed. Multimodal imaging techniques can provide more detailed diagnostic information to help physicians more accurately diagnose and treat diseases. Combining imaging methods to diagnose RAVF has rarely been reported. CASE SUMMARY: A 69-year-old female patient presented with gross hematuria that had persisted for 10 days. The patient underwent ultrasound examinations of the kidneys and renal blood vessels, enhanced computed tomography, three-dimensional computed tomography angiography, and digital subtraction angiography of the renal arteries. These revealed dilatation of the left renal vein and abnormal shunting between the left renal artery and vein. The patient was diagnosed with a left RAVF using combined multimodal imaging techniques. The patient was treated with left renal artery embolization immediately after renal arteriography. Hematuria resolved following the left renal artery embolization without serious bleeding or other complications. The patient made a full recovery after one year of postoperative follow-up. CONCLUSION: Multimodal imaging techniques complement each other when diagnosing RAVF, providing detailed diagnostic information that can aid in accurate diagnosis and treatment. In addition, this case reminds the sonographer to pay more attention to the color doppler flow imaging and blood flow spectrum when examining the kidney, so as to avoid misdiagnosis of renal cystic lesions as renal cysts and missed diagnosis of RAVF.