Pyelonephritis other imaging findings: Difference between revisions
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==Overview== | ==Overview== | ||
Other investigations might be used to diagnose pyelonephritis. Contrast nephrograms, intravenous pyelography, and urography are helpful in diagnosing pyelonephritis and its complications. | |||
==Other Imaging Findings== | ==Other Imaging Findings== | ||
Other investigations might be used to diagnose pyelonephritis. | |||
===Contrast Nephrograms=== | ===Contrast Nephrograms=== | ||
*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. | ||
*Striations result from stasis of contrast material within edematous tubules that demonstrates increasing attenuation over time. | *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]]. | *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. | *Delayed views of the infected kidney may demonstrate a nephrogram with increased attenuation. | ||
===Intravenous Pyelography=== | |||
Intravenous | * Intravenous pyelography (IVP) is done to diagnose an intrarenal or perinephric abscesses. IVP is a very sensitive radiological test for this purpose.<ref name="pmid6992728">{{cite journal| author=Hoverman IV, Gentry LO, Jones DW, Guerriero WG| title=Intrarenal abscess. Report of 14 cases. | journal=Arch Intern Med | year= 1980 | volume= 140 | issue= 7 | pages= 914-6 | pmid=6992728 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6992728 }} </ref> | ||
===Urography=== | ===Urography=== | ||
Urography can be used to diagnose patients with acute pyelonephritis and in some cases with xanthogranulomatous pyelonephritis<ref name="pmid2724423">{{cite journal| author=Sandberg T, Stokland E, Brolin I, Lidin-Janson G, Svanborg Edén C| title=Selective use of excretory urography in women with acute pyelonephritis. | journal=J Urol | year= 1989 | volume= 141 | issue= 6 | pages= 1290-4 | pmid=2724423 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2724423 }} </ref> | * Urography can be used to diagnose patients with acute pyelonephritis and in some cases with xanthogranulomatous pyelonephritis.<ref name="pmid2724423">{{cite journal| author=Sandberg T, Stokland E, Brolin I, Lidin-Janson G, Svanborg Edén C| title=Selective use of excretory urography in women with acute pyelonephritis. | journal=J Urol | year= 1989 | volume= 141 | issue= 6 | pages= 1290-4 | pmid=2724423 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2724423 }} </ref> | ||
* Classic urographic triad in diffuse xanthogranulomatous pyelonephritis consists of | |||
*Failure to respond to antibiotic therapy or recurrence of symptoms may be taken as an indication to perform urography | * Classic urographic triad in diffuse xanthogranulomatous pyelonephritis consists of: | ||
** Unilaterally decreased or (more commonly) absent renal excretion | |||
** A staghorn calculus | |||
** Poorly defined mass or diffuse [[Kidney|renal]] enlargement | |||
*Failure to respond to [[Antibiotic|antibiotic therapy]] or recurrence of symptoms may be taken as an indication to perform urography. | |||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Other investigations might be used to diagnose pyelonephritis. Contrast nephrograms, intravenous pyelography, and urography are helpful in diagnosing pyelonephritis and its complications.
Other Imaging Findings
Other investigations might be used to diagnose pyelonephritis.
Contrast Nephrograms
- 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 intrarenal or perinephric 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
- 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.