Pyelonephritis other imaging findings: Difference between revisions
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==Overview== | |||
Pyelonephritis is diagnosed with a typical history and presentation, a thorough physical exam, laboratory tests and diagnostic investigations like Xray, ultrasound, CT scan or MRI may be very helpful in this regard. Som other investigations can also be used to diagnose pyelonephritis under certain circumstances. | |||
==Other Imaging Findings== | ==Other Imaging Findings== | ||
Many other investigations are done to diagnose pyelonephritis. | |||
===Contrast Nephrograms=== | ===Contrast Nephrograms=== | ||
====Acute Pyelonephritis==== | ====Acute Pyelonephritis==== | ||
*Acute pyelonephritis consists of focal areas of striated or wedge-shaped [[hypoperfusion]], resulting in a characteristic striated nephrogram. | *Acute pyelonephritis consists of focal areas of striated or wedge-shaped [[hypoperfusion]], resulting in a characteristic striated nephrogram. | ||
Revision as of 21:43, 26 January 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pyelonephritis is diagnosed with a typical history and presentation, a thorough physical exam, laboratory tests and diagnostic investigations like Xray, ultrasound, CT scan or MRI may be very helpful in this regard. Som other investigations can also be used to diagnose pyelonephritis under certain circumstances.
Other Imaging Findings
Many other investigations are done to diagnose pyelonephritis.
Contrast Nephrograms
Acute Pyelonephritis
- Acute pyelonephritis consists of focal areas of striated or wedge-shaped hypoperfusion, resulting in a characteristic striated nephrogram.
- Striations result from stasis of contrast material within edematous tubules that demonstrates increasing attenuation over time.
- The infected kidney is usually enlarged, and there is often stranding in the perinephric fat.
- Delayed views of the infected kidney may demonstrate a nephrogram with increased attenuation.
Intravenous Pyelography
Intravenous Pyelography (IVP) is done to diagnose an intra-renal or peri-nephric abscesses. IVP is a very sensitive radiological test for this purpose.[1]
Urography
Urography can be used to diagnose patients with acute pyelonephritis and in some cases with xanthogranulomatous pyelonephritis[2]
- Classic urographic triad in diffuse xanthogranulomatous pyelonephritis consists of unilaterally decreased or (more commonly) absent renal excretion, a staghorn calculus, and a poorly defined mass or diffuse renal enlargement.
- Failure to respond to antibiotic therapy or recurrence of symptoms may be taken as an indication to perform urography
References
- ↑ Hoverman IV, Gentry LO, Jones DW, Guerriero WG (1980). "Intrarenal abscess. Report of 14 cases". Arch Intern Med. 140 (7): 914–6. PMID 6992728.
- ↑ Sandberg T, Stokland E, Brolin I, Lidin-Janson G, Svanborg Edén C (1989). "Selective use of excretory urography in women with acute pyelonephritis". J Urol. 141 (6): 1290–4. PMID 2724423.