CT imaging of acute and chronic pyelonephritis: a practical guide for emergency radiologists

被引:0
作者
Federica Vernuccio
Diana Patti
Roberto Cannella
Giuseppe Salvaggio
Massimo Midiri
机构
[1] University of Palermo,Dipartimento Promozione della Salute, Materno
[2] I.R.C.C.S. Centro Neurolesi Bonino Pulejo,Infantile, di Medicina Interna e Specialistica di Eccellenza G. D’Alessandro
[3] Université Paris VII,Hôpitaux Universitaires Beaujon, Radiology
[4] University Hospital “Paolo Giaccone”,Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND)
来源
Emergency Radiology | 2020年 / 27卷
关键词
Computed tomography; Imaging; Emergency; Pyelonephritis; Kidney;
D O I
暂无
中图分类号
学科分类号
摘要
Contrast-enhanced CT is not routinely indicated in uncomplicated urinary infections, but it may be necessary in patients with specific risk factors (i.e., diabetes, immunocompromised patients, history of stones, or prior renal surgery) or in patients not responding to antibiotics and in detecting complications of pyelonephritis. CT is the gold standard for imaging assessment of pyelonephritis severity. Imaging appearance of acute pyelonephritis, including focal (i.e., wedge-shaped zones of decreased attenuation or hypodense mass) and diffuse (i.e., global enlargement, poor parenchymal enhancement, lack of excretion of contrast, fat stranding) forms, needs to be differentiated from renal infarction, renal lymphoma, and interstitial nephritis. Chronic pyelonephritis—which appears as focal polar scars with underlying calyceal distortion, global atrophy, and hypertrophy of residual tissue—may mimic at imaging lobar infarcts. This pictorial essay reviews the CT imaging appearance of acute and chronic pyelonephritis, their uncommon subtypes, and their complications, with key features for early diagnosis. Their knowledge is crucial for emergency and abdominal radiologists to avoid misdiagnosis with malignancy and to guide the clinician towards the appropriate medical or surgical treatment.
引用
收藏
页码:561 / 567
页数:6
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