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Computed tomography of pyonephrosis

P J Fultz1, W R Hampton, S M Totterman

  • 1Department of Diagnostic Radiology, University of Rochester Medical Center, New York 14642.

Abdominal Imaging
|January 1, 1993
PubMed
Summary
This summary is machine-generated.

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Computed tomography (CT) can suggest pyonephrosis (kidney infection) with hydronephrosis (swollen kidney) via increased pelvic wall thickness. However, clinical signs of infection are more reliable indicators than CT findings alone.

Area of Science:

  • Radiology
  • Urology
  • Nephrology

Background:

  • Hydronephrosis, a swelling of the kidney, can be complicated by infection (pyonephrosis).
  • Accurate differentiation between infected and uninfected hydronephrosis is crucial for timely treatment.
  • Computed tomography (CT) is a key imaging modality for evaluating renal conditions.

Purpose of the Study:

  • To evaluate computed tomographic (CT) findings differentiating pyonephrotic from uninfected hydronephrotic kidneys.
  • To assess the diagnostic accuracy of specific CT parameters for pyonephrosis.

Main Methods:

  • Retrospective review of CT scans from 17 pyonephrotic and 20 uninfected hydronephrotic kidneys.
  • Evaluation of parameters: renal pelvic wall thickness, contents, parenchymal, and perirenal findings.

Related Experiment Videos

  • Correlation of CT findings with clinical signs of infection and subsequent percutaneous nephrostomy outcomes.

    • Main Results:

    • Common CT findings suggesting pyonephrosis include thickened renal pelvic walls and more severe perirenal fat changes compared to uninfected hydronephrosis.
    • However, individual CT findings were often not diagnostic for pyonephrosis.
    • The presence of clinical signs of infection alongside CT-detected hydronephrosis was a more sensitive indicator of pyonephrosis.

    Conclusions:

    • While CT can provide suggestive findings, it has limitations in definitively diagnosing pyonephrosis.
    • Clinical assessment of infection in patients with hydronephrosis on CT is essential for accurate diagnosis.
    • CT imaging should be interpreted in conjunction with clinical presentation for optimal management of hydronephrosis.