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Related Concept Videos

Acute Pyelonephritis I: Introduction01:27

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Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
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Acute Pyelonephritis II: Diagnostic Studies and Management01:28

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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Diffusion tensor imaging in acute pyelonephritis in children.

Mickaël Lair1, Mariette Renaux-Petel2, Adnan Hassani1

  • 1CHU C. Nicolle, Service de radiopédiatrie, Rouen University Hospital, Cedex, Rouen, France.

Pediatric Radiology
|May 24, 2018
PubMed
Summary

Diffusion tensor imaging (DTI) without respiratory triggering provides better image quality for diagnosing acute pyelonephritis in children compared to standard diffusion-weighted imaging (DWI). DTI shows comparable diagnostic accuracy for detecting nephritis areas.

Keywords:
ChildrenDiffusion tensor imagingDiffusion-weighted imagingKidneyMagnetic resonance imagingPyelonephritisUrinary tract infection

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Area of Science:

  • Pediatric Radiology
  • Medical Imaging
  • Renal Imaging

Background:

  • Magnetic resonance imaging (MRI) using diffusion-weighted imaging (DWI) is crucial for diagnosing acute pyelonephritis.
  • Respiratory triggering in MRI is challenging and time-consuming for pediatric patients.
  • Diffusion tensor imaging (DTI) offers a potential alternative for imaging moving kidneys without respiratory gating.

Purpose of the Study:

  • To compare the diagnostic performance and image quality of free-breathing DTI with respiratory-gated DWI for acute pyelonephritis in children.
  • To evaluate the feasibility of DTI as a substitute for DWI in pediatric renal imaging.

Main Methods:

  • Thirty-one children with suspected acute pyelonephritis were included.
  • Axial DTI was acquired during free breathing.
  • Axial and coronal DWI were acquired with respiratory triggering.

Main Results:

  • DTI showed excellent agreement with DWI in detecting nephritis.
  • There was no significant difference in the detection of nephritis areas between DTI and DWI.
  • Image quality was significantly superior with DTI compared to DWI (P<0.01).

Conclusions:

  • DTI is a viable alternative to DWI for diagnosing acute pyelonephritis in children.
  • DTI offers improved image quality and comparable diagnostic accuracy, potentially streamlining the MRI examination.
  • This technique may replace conventional DWI in pediatric renal imaging protocols.