Pyonephrosis CT: Difference between revisions
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{{Pyonephrosis}} | {{Pyonephrosis}} | ||
{{CMG}}; {{AE}} {{HVC}} | {{CMG}}; {{AE}} {{HVC}} | ||
==Overview== | |||
CT scan provides anatomic details and helps in distinguishing intrarenal and extrarenal pathologies but it is difficult to distinguish [[hydronephrosis]] from pyonephrosis on a CT scan. The indirect signs of pyonephrosis on CT scan include enlarged kidneys, presence of an infected collecting system in the setting of hydronephrosis, perinephric fat stranding, pelvic wall thickening, fluid-fluid levels, and gas within the collecting system. | |||
==CT scan== | ==CT scan== | ||
CT scan provides anatomic details and helps in distinguishing intrarenal and extrarenal pathologies. | |||
It is difficult to distinguish [[hydronephrosis]] from pyonephrosis on a CT scan. | |||
*The indirect signs of pyonephrosis on CT scan include<ref name="pmid18587250">{{cite journal| author=Stojadinović M, Mićić S, Milovanović D| title=Ultrasonographic and computed tomography findings in renal suppurations: performance indicators and risks for diagnostic failure. | journal=Urol Int | year= 2008 | volume= 80 | issue= 4 | pages= 389-97 | pmid=18587250 | doi=10.1159/000132697 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18587250 }} </ref>: | |||
*Enlarged kidneys | |||
*Presence of an infected collecting system in the setting of hydronephrosis. | |||
*Perinephric fat stranding | |||
*Striated nephrogram<ref name="pmid32792123">{{cite journal| author=Zulfiqar M, Ubilla CV, Nicola R, Menias CO| title=Imaging of Renal Infections and Inflammatory Disease. | journal=Radiol Clin North Am | year= 2020 | volume= 58 | issue= 5 | pages= 909-923 | pmid=32792123 | doi=10.1016/j.rcl.2020.05.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32792123 }} </ref> | |||
*Pelvic wall thickening | |||
*Fluid-fluid levels and gas within the collecting system can sometimes be seen | |||
*Other conditions like [[neoplasms]], [[nephrolithiasis]], congenital anomalies causing the obstruction. | |||
A few studies have shown Hounsfield Unit (HU) levels were higher in patients with pyonephrosis as compared to hydronephrosis which can help distinguish the two conditions. HU was found to be even higher in patients with sepsis.<ref name="pmid31541403">{{cite journal| author=Basmaci I, Sefik E| title=A novel use of attenuation value (Hounsfield unit) in non-contrast CT: diagnosis of pyonephrosis in obstructed systems. | journal=Int Urol Nephrol | year= 2020 | volume= 52 | issue= 1 | pages= 9-14 | pmid=31541403 | doi=10.1007/s11255-019-02283-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31541403 }} </ref><ref name="pmid33122830">{{cite journal| author=Boeri L, Fulgheri I, Palmisano F, Lievore E, Lorusso V, Ripa F | display-authors=etal| title=Hounsfield unit attenuation value can differentiate pyonephrosis from hydronephrosis and predict septic complications in patients with obstructive uropathy. | journal=Sci Rep | year= 2020 | volume= 10 | issue= 1 | pages= 18546 | pmid=33122830 | doi=10.1038/s41598-020-75672-8 | pmc=7596071 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33122830 }} </ref> | |||
==References== | ==References== | ||
Latest revision as of 11:11, 17 October 2021
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Pyonephrosis CT On the Web |
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American Roentgen Ray Society Images of Pyonephrosis CT |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Harsh Vardhan Chawla, M.B.B.S.[2]
Overview
CT scan provides anatomic details and helps in distinguishing intrarenal and extrarenal pathologies but it is difficult to distinguish hydronephrosis from pyonephrosis on a CT scan. The indirect signs of pyonephrosis on CT scan include enlarged kidneys, presence of an infected collecting system in the setting of hydronephrosis, perinephric fat stranding, pelvic wall thickening, fluid-fluid levels, and gas within the collecting system.
CT scan
CT scan provides anatomic details and helps in distinguishing intrarenal and extrarenal pathologies.
It is difficult to distinguish hydronephrosis from pyonephrosis on a CT scan.
- The indirect signs of pyonephrosis on CT scan include[1]:
- Enlarged kidneys
- Presence of an infected collecting system in the setting of hydronephrosis.
- Perinephric fat stranding
- Striated nephrogram[2]
- Pelvic wall thickening
- Fluid-fluid levels and gas within the collecting system can sometimes be seen
- Other conditions like neoplasms, nephrolithiasis, congenital anomalies causing the obstruction.
A few studies have shown Hounsfield Unit (HU) levels were higher in patients with pyonephrosis as compared to hydronephrosis which can help distinguish the two conditions. HU was found to be even higher in patients with sepsis.[3][4]
References
- ↑ Stojadinović M, Mićić S, Milovanović D (2008). "Ultrasonographic and computed tomography findings in renal suppurations: performance indicators and risks for diagnostic failure". Urol Int. 80 (4): 389–97. doi:10.1159/000132697. PMID 18587250.
- ↑ Zulfiqar M, Ubilla CV, Nicola R, Menias CO (2020). "Imaging of Renal Infections and Inflammatory Disease". Radiol Clin North Am. 58 (5): 909–923. doi:10.1016/j.rcl.2020.05.004. PMID 32792123 Check
|pmid=value (help). - ↑ Basmaci I, Sefik E (2020). "A novel use of attenuation value (Hounsfield unit) in non-contrast CT: diagnosis of pyonephrosis in obstructed systems". Int Urol Nephrol. 52 (1): 9–14. doi:10.1007/s11255-019-02283-2. PMID 31541403.
- ↑ Boeri L, Fulgheri I, Palmisano F, Lievore E, Lorusso V, Ripa F; et al. (2020). "Hounsfield unit attenuation value can differentiate pyonephrosis from hydronephrosis and predict septic complications in patients with obstructive uropathy". Sci Rep. 10 (1): 18546. doi:10.1038/s41598-020-75672-8. PMC 7596071 Check
|pmc=value (help). PMID 33122830 Check|pmid=value (help).