EURORAD ESR

Case 14683

Correlation of contrast-enhanced ultrasonography and computed tomography in complicated pyelonephritis

Author(s)
Dr George Skountzos

Athens General Hospital "Hippocration,
Radiology; 27,
Vasilissis Sofias Ave.
11527 Athens, Greece;
Email:georgeskou@yahoo.gr
 
Patient
female, 40 year(s)
 
 
  • Figure 1
    B-Mode ultrasound

    Enlargement of the right kidney and an upper pole hyperechoic mass (red circle) are visualized.

     
    Area of Interest: Urinary Tract / Bladder; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 2
    Colour Doppler

    Colour Doppler revealed low peripheral blood vessels. Resistance index (RI) of the segmental vessels of the right renal artery is increased.

     
    Area of Interest: Urinary Tract / Bladder; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 3
    CEUS-Early phase

    After the microbubbles intravenous administration, a low-perfusion lesion (red circle) was revealed.

     
    Area of Interest: Urinary Tract / Bladder; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 4
    CEUS-Delayed phase

    In delayed phase, the perfusion of the lesion remained poor (red circle).

     
    Area of Interest: Urinary Tract / Bladder; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 5
    CT-Nephrogram phase

    A low attenuating mass with low peripheral enhancement of the right kidney (red circle) was detected. Considering the clinical features of the patient, the findings implied complicated pyelonephritis.

     
    Area of Interest: Urinary Tract / Bladder; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 6
    Follow up CT-Nephrogram phase

    4 months later, a CT for follow-up reasons was performed, and a normal enhancement of both kidneys was revealed.

     
    Area of Interest: Urinary Tract / Bladder; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
Enlargement of the right kidney and an upper pole hyperechoic mass (red circle) are visualized.
 
Colour Doppler revealed low peripheral blood vessels. Resistance index (RI) of the segmental vessels of the right renal artery is increased.
 
After the microbubbles intravenous administration, a low-perfusion lesion (red circle) was revealed.
 
In delayed phase, the perfusion of the lesion remained poor (red circle).
 
A low attenuating mass with low peripheral enhancement of the right kidney (red circle) was detected. Considering the clinical features of the patient, the findings implied complicated pyelonephritis.
 
4 months later, a CT for follow-up reasons was performed, and a normal enhancement of both kidneys was revealed.
 
 
 
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