EURORAD ESR

Case 2161

Emphysematous pyelonephritis: sonographic diagnosis

Author(s)
Kehagias E, Daskalaki M, Megremis S, Andrianaki A, Cavallo G
 
Patient
female, 70 year(s)
 
 
  • Figure 1
    Sonography of the right kidney, on admission
     

    Longitudinal section of the right kidney where the two echogenic foci in the middle and lower pole of the kidney are demonstrated.

     
    Area of Interest: unknown; Imaging Technique: Sonography of the right kidney, on admission;

    Detailed section showing the presence of internal echoes in the shadow behind one of the echogenic pockets of gas ("dirty shadow").

     
    Area of Interest: unknown; Imaging Technique: Sonography of the right kidney, on admission;
     
     
  • Figure 2
    Abdominal CT scan
     

    CT scan showing the presence of gas inside the renal parenchyma and the extension of the inflammation in the perirenal space. Note the relatively increased size of the involved kidney.

     
    Area of Interest: unknown; Imaging Technique: Abdominal CT scan;

    CECT scan where radial non-enhanced segments are shown in the inflamed kidney.

     
    Area of Interest: unknown; Imaging Technique: Abdominal CT scan;
     
     
  • Figure 3
    Repeat ultrasonogram

    Repeat US during the 12th day of treatment showing the absorption of gas. Note the decreased echogenicity and increased thickness in the site of inflammation.

     
    Area of Interest: unknown; Imaging Technique: Repeat ultrasonogram;
     
     
  • Figure 4
    Power-Doppler image of the right kidney

    Power-Doppler image of the right kidney 20 days after admission to the hospital. The focal decrease in the echogenicity of the renal parenchyma is still remaining in the middle. Also note the low blood flow in the...

     
    Area of Interest: unknown; Imaging Technique: Power-Doppler image of the right kidney;
     
     
Longitudinal section of the right kidney where the two echogenic foci in the middle and lower pole of the kidney are demonstrated.
 
Detailed section showing the presence of internal echoes in the shadow behind one of the echogenic pockets of gas ("dirty shadow").
 
CT scan showing the presence of gas inside the renal parenchyma and the extension of the inflammation in the perirenal space. Note the relatively increased size of the involved kidney.
 
CECT scan where radial non-enhanced segments are shown in the inflamed kidney.
 
Repeat US during the 12th day of treatment showing the absorption of gas. Note the decreased echogenicity and increased thickness in the site of inflammation.
 
Power-Doppler image of the right kidney 20 days after admission to the hospital. The focal decrease in the echogenicity of the renal parenchyma is still remaining in the middle. Also note the low blood flow in the region.
 
 
 
Home Search Sections Teaching Cases History FAQ Case Archives Contact Login Disclaimer Imprint Switch to MOBILE version
View desktop version