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Computerized tomography attenuation values can be used to differentiate hydronephrosis from pyonephrosis.

Emrah Yuruk1, Murat Tuken2, Suhejb Sulejman2

  • 1Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey. emrah.yuruk@yahoo.com.

World Journal of Urology
|July 3, 2016
PubMed
Summary

Computerized tomography (CT) Hounsfield unit (HU) values can differentiate pyonephrosis from hydronephrosis. A HU of 9.21 or higher accurately identifies pyonephrosis, potentially preventing septic complications.

Keywords:
Attenuation valueComputerized tomographyHounsfield unitHydronephrosisPyonephrosis

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Area of Science:

  • Radiology
  • Urology
  • Medical Imaging

Background:

  • Hydronephrosis, characterized by urine backflow, can lead to infection.
  • Pyonephrosis, a severe form of infected hydronephrosis, requires prompt diagnosis and treatment.
  • Differentiating pyonephrosis from non-infected hydronephrosis is crucial for appropriate patient management.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of computerized tomography (CT) attenuation values in distinguishing pyonephrosis from hydronephrosis.
  • To determine the optimal Hounsfield unit (HU) threshold for differentiating these conditions.

Main Methods:

  • Retrospective analysis of abdominopelvic CT scans from 105 patients with grades 1-3 hydronephrosis.
  • Measurement of collecting system surface area and attenuation values (HU) by three physicians.
  • Comparison of mean HU and urine culture results between pyonephrosis and hydronephrosis groups.

Main Results:

  • Pyonephrosis was present in 44.8% of patients.
  • Mean collecting system surface areas were similar between groups (p=0.735).
  • Mean HU was significantly higher in pyonephrosis (13.51 ± 13.29 HU) than hydronephrosis (4.67 ± 5.37 HU, p=0.0001).
  • A HU threshold of 9.21 provided 65.96% sensitivity and 87.93% specificity for pyonephrosis diagnosis.

Conclusions:

  • CT-derived attenuation values (HU) are valuable in differentiating pyonephrosis from hydronephrosis.
  • Utilizing HU measurements can aid in early diagnosis and prevent severe septic complications associated with pyonephrosis.