Renal imaging in pyelonephritis

Shen, Y.G.; Brown, Mark

doi:10.1111/j.1440-1797.2003.00226.x

Cited by 23 publications

(14 citation statements)

References 10 publications

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“…In this journal, 16% of patients were found to have new and clinically significant abnormal findings. But there was no significant difference between the groups with abnormal renal imaging and those with normal renal imaging in terms of any easily detectable clinical parameter, such as change in serum creatinine, premorbid conditions, age, days for fever to resolve, or white cell count on admission [6]. This finding suggests that early imaging is a cost-effective part of management.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, making an exact clinical correlation with the various stages of inflammation that cause abscess, calculi, or obstruction, all of which require immediate intervention or an appropriate surgical procedure, is impossible [4]. In this context, recent studies have emphasized the importance of early imaging [5,6]. Improving prognosis by identifying abnormalities, such as complications, that cannot be detected by clinical findings or laboratory findings is important.…”

Section: Introductionmentioning

confidence: 99%

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Diagnosing Acute Pyelonephritis with CT,^99mTc-DMSA SPECT, and Doppler Ultrasound: A Comparative Study

et al. 2010

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PurposeWith growing interest in early imaging, the aim of our study was to define the most practical modality for routine clinical use for the diagnosis of acute pyelonephritis (APN). We compared the sensitivity of enhanced computerized tomography (CT), dimercaptosuccinic acid (DMSA) scintigraphy, and Doppler ultrasonography (DUS) by using clinical findings as the standard of reference.Materials and MethodsA total of 207 APN patients (191 women, 16 men; mean age, 49.4 years; range, 17-88 years) were enrolled in this study. All the patients underwent imaging modalities during hospitalization. SPECT images were obtained 4 hours after injection of 99mTc-DMSA. Transverse and coronary CT images were obtained before and after injection of the contrast agent. DUS was performed in the longitudinal, transverse, and coronal planes. All the images were read independently by a single radiologist and a nuclear medicine specialist. The sensitivity of each modality for detecting APN was compared.ResultsCT showed significantly superior sensitivity compared with that of DUS (81.0% vs. 33.3%, respectively, n=147). DMSA scintigraphy also showed significantly superior sensitivity compared with that of DUS (74.7% vs. 33.3%, respectively, n=150). Compared with DMSA scintigraphy, CT showed superior sensitivity, but the difference was not statistically significant (81.0% vs. 74.8%, respectively, n=147, p=0.163).ConclusionsFor cases of clinically suspected APN, CT and DMSA scintigraphy appear to be equally sensitive and reliable for detecting APN, although CT is more practical in various fields. DUS was significantly less sensitive.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diagnosing Acute Pyelonephritis with CT,^99mTc-DMSA SPECT, and Doppler Ultrasound: A Comparative Study

et al. 2010

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“…I nostri dati preliminari confermano osservazioni già fatte in precedenza 9 . È importante notare che in alcuni casi sono assenti alcuni dei sintomi considerati tra i più suggestivi di pielonefrite acuta: in particolare, 2 pazienti con infezione alta e danno renale dimostrato, non avevano dolore lombare, che, al contrario, era presente in tutte le pazienti non affette da pielonefrite acuta.…”

Section: Discussioneunclassified

Acute pyelonephritis in ER

et al. 2007

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Materiale protetto da copyright. Non fotocopiare o distribuire elettronicamente senza l'autorizzazione scritta dell'editore. IntroduzioneLe infezioni delle alte vie urinarie (IAVU) non complicate rappresentano una possibile causa di danno renale permanente. La sintomatologia clinica di queste infezioni è spesso caratteristica, ma la distinzione tra forme a differente livello di coinvolgimento delle vie urinarie richiede il ricorso a sofisticati mezzi di diagnostica radiologica per immagini. Soprattutto in un ambiente come il DEA, la possibilità di distinguere infezioni delle alte vie urinarie con o senza coinvolgimento renale, è spesso una impresa ardua, e si rischia o di sottovalutare il livello di estensione dell'infezione oppure di sottoporre troppi pazienti con infezione limitata a inutili e costose procedure diagnostiche e terapeutiche 1 . Il danno renale da nefrite infettiva viene spesso non diagnosticato, e questo dato è preoccupante se si pensa che cicatrici parenchimali anche poco estese possono portare nel tempo a diversi gradi di insufficienza d'organo, soprattutto se concomitano altri fattori purtroppo non così rari, come l'abuso di analgesici o anomalie congenite 2 . L'approccio terapeutico e il follow up cambiano in maniera consistente nei pazienti affetti da IAVU non complicata o primitiva, in presenza o meno di localizzazione renale dimostrabile radiologicamente. La cistopielite (IAVU senza coinvolgimento parenchimale renale) è un'infezione realmente superficiale, e si verifica in un punto anatomico in cui facilmente si ottengono elevate concentrazioni di antibiotici 3 . L'infezione renale parenchimale coinvolge invece il tessuto profondo, nel quale le difese naturali sono rese meno efficaci da un ambiente fisico-chimico ostile e la L La a p pi ie el lo on ne ef fr ri it te e a ac cu ut ta a i in n D DE EA A

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“…Recent reports imply the importance of early imaging. Shen and Brown stated that early imaging is cost-effective and advocate imaging in people who are going to be hospitalized by APN (14,15). Yoo et al (14) reported that there are clinically significant findings in 16% of the patients.…”

Section: Urinary Tract Infectionsmentioning

confidence: 99%

Acute Flank Pain: Multi-detector Computed Tomographic Evaluation in the Emergency Room

Aktürk¹,

Güneş²,

Hekįmoğlu³

2017

EAJEM

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Renal imaging in pyelonephritis

Cited by 23 publications

References 10 publications

Diagnosing Acute Pyelonephritis with CT,^99mTc-DMSA SPECT, and Doppler Ultrasound: A Comparative Study

Diagnosing Acute Pyelonephritis with CT,^99mTc-DMSA SPECT, and Doppler Ultrasound: A Comparative Study

Acute pyelonephritis in ER

Acute Flank Pain: Multi-detector Computed Tomographic Evaluation in the Emergency Room

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Renal imaging in pyelonephritis

Cited by 23 publications

References 10 publications

Diagnosing Acute Pyelonephritis with CT,99mTc-DMSA SPECT, and Doppler Ultrasound: A Comparative Study

Diagnosing Acute Pyelonephritis with CT,99mTc-DMSA SPECT, and Doppler Ultrasound: A Comparative Study

Acute pyelonephritis in ER

Acute Flank Pain: Multi-detector Computed Tomographic Evaluation in the Emergency Room

Contact Info

Product

Resources

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Diagnosing Acute Pyelonephritis with CT,^99mTc-DMSA SPECT, and Doppler Ultrasound: A Comparative Study

Diagnosing Acute Pyelonephritis with CT,^99mTc-DMSA SPECT, and Doppler Ultrasound: A Comparative Study