Contrast-enhanced ultrasound for the diagnosis of acute pyelonephritis in pediatric patients with urinary tract infection: A feasibility study

Lee, Han Byeol; Choi, Young Hun; Cheon, Jung Hee; Lee, Seul Bi; Cho, Yeon Jin; Ahn, Yo Han; Lim, Seon Hee

doi:10.1371/journal.pone.0284016

Cited by 2 publications

(1 citation statement)

References 21 publications

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“…Contrast-enhanced ultrasound (CEUS) is increasingly used in clinical practice as the first diagnostic method used for patients with suspected pyelonephritis rather than abdominal CT with contrast medium, especially in young subjects [8,9]. CEUS can show areas of hypoenhancement in the arterial phase and early de-enhancement in the late phase [10,11].…”

Section: Introductionmentioning

confidence: 99%

Contrast-Enhanced Ultrasound Follow-Up for Acute Pyelonephritis Patients

Boccatonda,

Venerato,

D’Ardes

et al. 2023

Healthcare

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Contrast-enhanced ultrasound (CEUS) is increasingly used in clinical practice as the first diagnostic method in patients with suspected pyelonephritis rather than abdominal CT with contrast medium, especially in young subjects. We performed a retrospective analysis on patients in for whom a CEUS examination was utilized as a follow-up method after acute pyelonephritis as normal clinical practice. Through evaluating all patients, in terms duration between CEUS examination and normalization (healing) of the renal disease, we found that the mean duration is 25.9 days. Our ultrasound findings did not induce any therapeutic modifications, not even in the cases in which the examination was repeated several times. Therefore, setting up a CEUS follow-up examination after 25 days from the first diagnosis can reduce the number of repeated tests, benefitting patients and the healthcare system in terms of reducing costs.

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Section: Introductionmentioning

confidence: 99%

Contrast-Enhanced Ultrasound Follow-Up for Acute Pyelonephritis Patients

Boccatonda,

Venerato,

D’Ardes

et al. 2023

Healthcare

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Diffusion-weighted MRI in the identification of renal parenchymal involvement in children with a first episode of febrile urinary tract infection

Anfigeno,

La Valle,

Castagnola

et al. 2024

Front. Radiol.

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AimsThis study aims to assess the diagnostic accuracy of diffusion-weighted Magnetic Resonance Imaging (DW-MRI) and determine the inter-reader agreement between two expert radiologists in detecting pyelonephritic foci during the initial episode of febrile urinary tract infection (fUTI) in children aged 0–5 years. Also, we aim to establish the correlation between clinical data and DW-MRI findings.MethodsChildren aged 0–5 years presenting with their first episode of fUTI were included in the study and underwent DW-MRI and Ultrasound (US) examinations within 72 h of admission. Inter-observer agreement between the two expert radiologists in assessing DW-MRI scans was evaluated using Cohen's kappa statistic. Clinical and laboratory data were subjected to statistical analysis.Results84 children (40 male, 44 female) with a mean age of 7.3 (SD 6.2) months were enrolled. DW-MRI detected pyelonephritis in 78 out of 84 cases (92.9%), with multiple foci observed in 73 out of 78 cases (93.6%). There was a “substantial” level of agreement between the two expert radiologists (κ = 0.725; observed agreement 95.2%). Renal US revealed pyelonephritis in 36 out of 78 cases (46.2%). White blood cell (WBC) count (p = 0.04) and lymphocyte count (p = 0.01) were significantly higher in patients with positive DW-MRI. Although not statistically significant, patients with positive DW-MRI had higher mean values of C-Reactive Protein, Procalcitonin, and neutrophil WBC count (7.72 mg/dl, 4.25 ng/dl, and 9,271 /μl, respectively).ConclusionsDW-MRI exhibited excellent diagnostic performance in detecting pyelonephritic foci, with substantial inter-reader agreement among expert radiologists, indicating the reliability of the technique. However, a weak correlation was observed between laboratory parameters and DW-MRI results, potentially because of the low rate of negative DW-MRI findings.

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Contrast-enhanced ultrasound for the diagnosis of acute pyelonephritis in pediatric patients with urinary tract infection: A feasibility study

Cited by 2 publications

References 21 publications

Contrast-Enhanced Ultrasound Follow-Up for Acute Pyelonephritis Patients

Contrast-Enhanced Ultrasound Follow-Up for Acute Pyelonephritis Patients

Diffusion-weighted MRI in the identification of renal parenchymal involvement in children with a first episode of febrile urinary tract infection

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