Relationship Between Uncommon Computed Tomography Findings and Clinical Aspects in Patients With Acute Pyelonephritis.
10.4111/kju.2014.55.7.482
- Author:
Jang Sik KIM
1
;
Sangwook LEE
;
Kwang Woo LEE
;
Jun Mo KIM
;
Young Ho KIM
;
Min Eui KIM
Author Information
1. Department of Urology, Soonchunhyang University College of Medicine, Cheonan, Korea. urojun@schmc.ac.kr
- Publication Type:Original Article
- Keywords:
Pyelonephritis;
X-ray computed tomography
- MeSH:
Abscess/etiology/radiography;
Acute Disease;
Adipose Tissue/pathology/radiography;
Adult;
Edema/etiology/radiography;
Female;
Humans;
Kidney Diseases/radiography;
Middle Aged;
Pyelonephritis/complications/pathology/*radiography;
Retrospective Studies;
Tomography, X-Ray Computed/methods;
Ureteral Diseases/etiology/radiography
- From:Korean Journal of Urology
2014;55(7):482-486
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Computed tomography (CT) has become popular in the diagnosis of acute pyelonephritis (APN) and its related complications in adults. The aim of this study was to investigate the relationship between uncommon CT findings and clinical and laboratory data in patients with APN. MATERIALS AND METHODS: From July 2009 to July 2012, CT findings and clinical data were collected from 125 female patients with APN. The six uncommon CT findings (excluding a wedge-shaped area of hypoperfusion in the renal parenchyma) studied were perirenal fat infiltration, ureteral wall edema, renal abscess formation, pelvic ascites, periportal edema, and renal scarring. The clinical parameters analyzed were the age and body mass index of the patients as well as the degree and duration of fever. Laboratory parameters related to inflammation and infection included white blood cell count, C-reactive protein (CRP) level, erythrocyte sedimentation rate, pyuria, and bacteriuria. RESULTS: The most common CT finding was perirenal fat infiltration (69 cases, 55%). A longer duration of fever, higher CRP level, and grade of pyuria were related with perirenal fat infiltration (p=0.010, p=0.003, and p=0.049, respectively). The CRP level was significantly higher in patients with renal abscess and ureteral wall edema (p=0.005 and p=0.015, respectively). CONCLUSIONS: The uncommon CT findings that were related to aggravated clinical and laboratory parameters of APN patients were perirenal fat infiltration, ureteral wall edema, and renal abscess formation. The inflammatory reaction and tissue destruction may be more aggressive in patients with these CT findings.
