Pyelonephritis CT scan: Difference between revisions

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Image:Xanthogranulomatous pyelonephritis 002.jpg|CT image demonstrates right xanthogranulomatous pyelonephritis
Image:Xanthogranulomatous pyelonephritis 002.jpg|CT image demonstrates right xanthogranulomatous pyelonephritis
Image:Xanthogranulomatous pyelonephritis 003.jpg|CT image demonstrates right xanthogranulomatous pyelonephritis
Image:Xanthogranulomatous pyelonephritis 003.jpg|CT image demonstrates right xanthogranulomatous pyelonephritis
Image:Xanthogranulomatous-pyelonephritis-2.jpg|CT image demonstrates right xanthogranuomatous pyelonephritis with dilated calyces
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Revision as of 15:25, 27 January 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

PMID: 12848478 and 2651759 and 2388315 and 17318482 and 2798873

Overview

A CT scan can be used to detect pyelonephritis. [1][2]

CT

A CT scan usually shows[3]

  • Round swollen kidneys
  • Hypo-dense appearance
  • Abscesses may air may not be present

Acute Pyelonephritis

Images courtesy of RadsWiki

Chronic Pyelonephritis

Imaging findings are characterized by renal scarring, atrophy and cortical thinning, hypertrophy of residual normal tissue, caliceal clubbing secondary to retraction of the papilla from overlying scar, thickening and dilatation of the caliceal system, and overall renal asymmetry. Images courtesy of RadsWiki

Emphysematous Pyelonephritis

  • Additional evaluation with CT will confirm the presence and extent of parenchymal gas and will often allow identification of the source of obstruction when present.
  • The use of intravenous contrast material will often reveal asymmetric renal enhancement or delayed excretion, and, during the nephrographic phase, will help identify areas of focal tissue necrosis or abscess formation.

Images courtesy of RadsWiki

Xanthogranulomatous Pyelonephritis

The CT findings of xanthogranulomatous pyelonephritis are pathognomonic in most cases: diffuse reniform enlargement with ill-defined central low attenuation, apparent cortical thinning, and central calculi.

Images courtesy of RadsWiki

References

  1. Fowler JE, Perkins T (1994). "Presentation, diagnosis and treatment of renal abscesses: 1972-1988". J Urol. 151 (4): 847–51. PMID 8126807.
  2. Gupta K, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG; et al. (2011). "International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases". Clin Infect Dis. 52 (5): e103–20. doi:10.1093/cid/ciq257. PMID 21292654.
  3. Meyrier A, Condamin MC, Fernet M, Labigne-Roussel A, Simon P, Callard P; et al. (1989). "Frequency of development of early cortical scarring in acute primary pyelonephritis". Kidney Int. 35 (2): 696–703. PMID 2651759.

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