The role of power Doppler ultrasonography in the diagnosis of acute pyelonephritis

Sakarya,; Arslan,; Erkoç,; Bozkurt,; Atilla,

doi:10.1046/j.1464-410x.1998.00555.x

Cited by 33 publications

(20 citation statements)

References 23 publications

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“…More recent studies have shown that PDS has fairly high sensitivity and specificity for the evaluation of APN and is superior to color Doppler sonography. [22][23][24] Although the lack of ionizing radiation or contrast injection is the advantage of PDS, it is a time-consuming procedure and is difficult to Patients with…”

Section: A C D B E F Discussionmentioning

confidence: 99%

Untitled

2001

J of Ultrasound Medicine

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The purpose of this study was to evaluate the ability of pulse inversion harmonic imaging with or without microbubble ultrasonographic contrast agent in depicting renal parenchymal changes in acute pyelonephritis. The study population included 30 patients with acute pyelonephritis and 10 healthy volunteers. Pulse inversion harmonic imaging with or without contrast agent was compared with conventional ultrasonography and tissue harmonic imaging in terms of detection and conspicuity of renal abnormalities. The detection and conspicuity of renal parenchymal abnormalities in acute pyelonephritis on tissue harmonic imaging, pulse inversion harmonic imaging, and contrast-enhanced pulse inversion harmonic imaging were significantly better than those on conventional ultrasonography. In 2 of 10 healthy volunteers all 4 techniques yielded false-positive diagnoses of parenchymal abnormalities. In conclusion, tissue harmonic imaging and pulse inversion harmonic imaging are sensitive techniques for depicting renal parenchymal lesions in acute pyelonephritis. Despite relatively lower specificities and negative predictive values, these techniques are thought to be useful for the depiction of subtle parenchymal changes in acute pyelonephritis.

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Section: A C D B E F Discussionmentioning

confidence: 99%

Untitled

2001

J of Ultrasound Medicine

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“…I u svojoj studiji Dell Atti L. [13] pokazuje da sa senzitivnošću od 76 %, i specifičnošću od 75 %, upotreba Dopler ultrazvuka je velika i nezaobilazna u dijagnostikovanju i praćenju akutnog pijelonefritisa. Nadalje, u studiji Sakarya ME i saradnika [14] uloga Dopler ultrasonografskog ispitivanja akutnog pijelonefritisa je nezaobilazna sa senzitivnošću od 88% i kompletnom specifičnošću. Mada u studiji koju su radili Berro Y i autori, [15] ukazano je da je Dopler ultrasonografsko ispitivanje korisno u dijagnostikovanju, ali nedovoljno da zameni DMSA scintigrafiju.…”

Section: Tabela 8 Ultrasonografski Parametri Koji Ukazuju Na Akutni unclassified

Significance of echotomography in the diagnostic algorithm for acute pyelonephritis and glomerulonephritis

Bogosavljević¹,

Gašić²,

Filipović³

et al. 2015

Praxis Med

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Bogosavljević I. , Gašić M. , Filipović T. , Mandić P. , Đukić-Macut N. , Šaranović M. , Stajić S. ¹Institut za Anatomiju, Medicinski fakultet Priština, Kosovska Mitrovica, Srbija ²Služba za radiološku dijagnostiku, KBC "Dr Dragiša Mišović", Dedinje, Beograd, SrbijaUvod: U odraslih se dijagnostikovanje akutnih pijelonefritisa i glomerulonefritisa prvenstveno bazira na kliničkom i laboratorijsko-biohemijskom ispitivanju. Kod osoba kod kojih je klinička slika atipična, i kod osoba koje ne reaguju na terapiju pribegava se radiološkom ispitivanju. Ehotomografsko ispitivanje je nezaobilazno u dijagnostičkom algoritmu. Cilj: Cilj ovog istraživanja je bio da se ustanove pojedini ehotomografski parametri, kao i da se odredi njihova dijagnostička moć kod pacijenata obolelih od akutnih infekcija pijelo-kaliksnog sistema i parenhima bubrega (pijelonefritis i glomerulonefritis), a upoređujući ih sa adekvatnim referentnim testovima. Materijal i metode: Urađena je studija preseka u periodu od oktobra 2014. god. do maja 2015. god. Obuhvaćeno je 50 ispitanika sa akutnom inflamacijom parenhima bubrega i pijelokaliksnog sistema kojima je učinjen ehotomografski pregled abdomena i male karlice, u okviru Službe za radiološku dijagnostiku KBC "Dr Dragiša Mišović-Dedinje" u Beogradu. Ehotomografski pregledi bubrega su obuhvatali ispitivanje mnogobrojnih parametara koji bi mogli da ukažu na postojanje akutne inflamacije parenhima bubrega odnosno pijelo-kaliksnog sistema. Za zlatni standard smo uzimali nalaz dobijen CT (kompjuterizovana tomografija) snimanjem abdomena i male karlice, kao i pato-histološkim nalazom dobijenim biopsijom tankom iglom. Rezultati: Od 50 ispitanika sa akutnom inflamacijom gornjeg urinarnog trakta, 41 pacijent (82 %) je imao akutni pijelonefritis, dok je 9 (18 %) imalo akutni glomerulonefritis. Kod 70% ispitanika sa akutnim pijelonefritisom (29 osoba) bilo je prisutno uvećanje bubrega gde je senzitivnost testa 79,3 %, a specifičnost testa 91,7 %. Tačnost metode iznosila je 82,9 % kada su posmatrani parametri: gubitak centralnog eho-kompleksa i nejasna kortiko-medularna diferencijacija. Senzitivnost testa u kome su posmatrane karakteristike pijelo-kaliksnog sistema iznosila je 65 %, a specifičnost 90 %. Analizom prisustva kalkulusa u parenhimu bubrega dolazi se do vrednosti senzitivnosti testa od 54,8 %, a specifičnosti od 80 %. Hipoehogeni fokusi u parenhimu bubrega, uvećanje bubrega i gubitak kortikomedularne granice su parametri koji sa velikom senzitivnošću i specifičnošću ukazuju na akutni glomerulonefritis. Zaključak: Na osnovu visokih vrednosti senzitivnosti i specifičnosti testiranih pregleda procenjujemo da ultrazvučna dijagnostika ima obavezno mesto u djagnostičkom algoritmu. Upotreba ultrazvučnih aparata koji pružaju mogućnost visoko rezolutivnih pregleda, kao i široka dostupnost i dobra reproducibilnost metode, uz nisku cenu pregleda, idu u prilog prve eksploracije ultrazvučnim pregledom. Multidetektorsko CT skeniranje i biopsija tankom iglom ipak ostaje metoda izbora u postavljanju konačne dijagnoze.

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“…US presents a much lower sensitivity than CT [35,36], revealing some pathological features just in 40% of subjects with a positive CT [37]. US may reveal renal enlargement with a reduced visibility of renal sinus which appears focally or diffusely compressed, especially in young patients since in adults nephrosclerosis may be present.…”

Section: Acute Renal Infectionsmentioning

confidence: 99%

“…Renal and perinephric abscesses may appear as fluid collections or as complex lesions with or without layers of debris or air. In children and young adults CD and PD analysis increase the sensitivity of US in detecting acute pyelonephritis up to 63% [38,39,40] by revealing single or multiple hypoperfused renal regions determined by inflammatory oedema (Fig. 9).…”

Section: Acute Renal Infectionsmentioning

confidence: 99%

Renal parenchymal diseases: Is characterization feasible with ultrasound?

Quaia

Bertolotto

2002

Eur Radiol

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Ultrasound (US) imaging of the kidneys has greatly improved in recent years with introduction of wideband transducers and advances is beamformer technology. US is often the first imaging technique to be employed in patients with renal failure, haematuria or proteinuria, after clinical and laboratory evaluation. After conventional US evaluation, Doppler US (DUS) and resistive indices (RIs) analysis provide renal functional evaluation. Anyway, both sensitivity and specificity of conventional US and DUS in renal parenchymal disease evaluation remains low. In the initial or mild clinical stages of renal parenchymal diseases, kidneys may present normal US morphological appearance and normal RIs values, whereas different renal parenchymal diseases may reveal similar appearance on US and DUS evaluation. Besides, different renal parenchymal diseases may present some distinct features on conventional US and DUS with colour Doppler (CD) and power Doppler (PD) evaluation, even though percutaneous renal biopsy is often necessary to reach definite diagnosis. Renal vasculitides and tubular-interstitial nephropathies are more frequently identified by conventional US and DUS than glomerular nephropathies, since glomerular component accounts only for 8% of the renal parenchyma, whereas the highest percentage is occupied by vascular and tubulo-interstitial component. Follow-up of acute renal failure, during and after medical treatment, is the most useful field of employment of conventional US and DUS techniques, since a progressive lowering of RIs is correlated to a progressive recovery of renal function.

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The role of power Doppler ultrasonography in the diagnosis of acute pyelonephritis

Cited by 33 publications

References 23 publications

Untitled

Untitled

Significance of echotomography in the diagnostic algorithm for acute pyelonephritis and glomerulonephritis

Renal parenchymal diseases: Is characterization feasible with ultrasound?

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