title: Utility of non-enhanced magnetic resonance imaging to detect acute pyelonephritis.
abstract: It has been established that enhanced computed tomography (CT) and (99m) Tc-dimercaptosuccinic acid renal scintigraphy ((99m) Tc-DMSA scintigraphy) used in conjunction with single-photon emission CT is a useful tool for the diagnosis of acute pyelonephritis (APN). The utility of non-enhanced magnetic resonance imaging (MRI), however, has not been investigated extensively for the diagnosis of APN or renal abscess in children. We describe the case of a 23-month-old boy with suspected APN who received non-enhanced MRI. Whole body diffusion-weighted imaging (DWI) was used, and a background body-signal suppression sequence was applied. High-intensity focal lesions were identified on DWI and low-intensity lesions on the apparent diffusion coefficient map in the acute phase. This case suggested that non-enhanced MRI could be a useful tool for the diagnosis of APN in children, because it can avoid the risks of not only radiation exposure but also nephrogenic systemic fibrosis associated with gadolinium-based contrast agents, especially in infants.
authors.affiliation: Department of Pediatrics, Jichi Medical University, Tochigi, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Aoyagi
authors.forename: Jun
authors.initials: J
authors.lastname: Odaka
authors.forename: Yuri
authors.initials: Y
authors.lastname: Kuroiwa
authors.forename: Naomi
authors.initials: N
authors.lastname: Nakashima
authors.forename: Takane
authors.initials: T
authors.lastname: Ito
authors.forename: Takashi
authors.initials: T
authors.lastname: Saito
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kanai
authors.forename: Takanori
authors.initials: T
authors.lastname: Yamagata
authors.forename: Mariko Y
authors.initials: MY
authors.lastname: Momoi
mesh_terms: D000208:Acute Disease; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D011704:Pyelonephritis / Q000175:diagnosis*
keywords: acute pyelonephritis; apparent diffusion coefficient map; children; diffusion-weighted imaging; non-enhanced magnetic resonance imaging