title: Acute complicated pyelonephritis: contrast-enhanced ultrasound.
abstract: Imaging is required if complication is suspected in acute pyelonephritis to assess the nature and extent of the lesions, and to detect underlying causes. The current imaging modality of choice in clinical practice is computed tomography. Because of associated radiation and potential nephrotoxicity, CEUS is an alternative that has been proven to be equally accurate in the detection of acute pyelonephritis renal lesions. The aims of this study of 48 patients are to describe in detail the CEUS findings in acute pyelonephritis, and to determine if abscess and focal pyelonephritis may be distinguished. Very characteristic morphologic and temporal patterns of enhancement are described. These allow differentiation of focal pyelonephritis from renal abscess, and detection of tiny suppurative foci within focal pyelonephritis. The detection of abscesses is important because follow-up in 25 patients revealed a longer clinical course. Typical pyelonephritis CEUS features permit distinction from other renal lesions. As a whole, CEUS is an excellent tool in the work-up of complicated acute pyelonephritis, so it may be considered as the imaging technique of choice in the evaluation and follow-up of these patients who frequently are very young, so as to minimise radiation exposure.
authors.affiliation: Servicio de Radiología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain. tfontanilla@telefonica.net
authors.forename: Teresa
authors.initials: T
authors.lastname: Fontanilla
authors.forename: Javier
authors.initials: J
authors.lastname: Minaya
authors.forename: Cristina
authors.initials: C
authors.lastname: Cortés
authors.forename: Concepción González
authors.initials: CG
authors.lastname: Hernando
authors.forename: Rafael Pérez
authors.initials: RP
authors.lastname: Arangüena
authors.forename: Jesús
authors.initials: J
authors.lastname: Arriaga
authors.forename: Maria Soledad
authors.initials: MS
authors.lastname: Carmona
authors.forename: Ana
authors.initials: A
authors.lastname: Alcolado
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D007674:Kidney Diseases / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011704:Pyelonephritis / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D055815:Young Adult