Clinical Usefulness of Unenhanced Computed Tomography in Patients with Acute Pyelonephritis
Journal of Korean Medical Science
; : e236-2018.
Article
in English
| WPRIM (Western Pacific)
| ID: wpr-717201
Responsible library:
WPRO
ABSTRACT
BACKGROUND:
Unenhanced computed tomography (UCT) may be useful for evaluating acute pyelonephritis; however, no study has compared UCT with enhanced computed tomography (ECT) as a diagnostic tool. We evaluated a clinical usefulness of UCT versus ECT in acute pyelonephritis (APN).METHODS:
We reviewed the clinical and radiological data from 183 APN-suspected patients who underwent UCT and ECT simultaneously at emergency room (ER) over a two-year period. Demographic, clinical parameters and computed tomography (CT) parameters of 149 patients were compared.RESULTS:
The average patient age was 61.2 (± 10) years 31 patients were men. Ninety-nine (66.4%) patients showed stones (18.7%), perinephric infiltration (56%), swelling (21%), and hydronephrosis (6.7%) on UCT. Seventeen patients (11.4%) had an atypical clinical course, requiring additional tests for accurate diagnosis. In 7 patients UCT and ECT results did not differ; in 10 patients, the diagnosis changed on ECT. On ECT, 112/149 (75.2%) patients had stones (16.7%), perinephric infiltrations (57%), swelling (21%), and hydronephrosis (6.7%); 62.5% showed parenchymal involvement 34 (22.8%) patients had no abnormal ECT findings. APN CT findings are similar on stone, perinephric infiltration, swelling and hydronephrosis on both CTs. Twelve patients (8.0%) had an abnormal ECT finding, i.e., low-grade (1 and 2) parenchymal involvement. Six (4%) patients developed contrast-induced acute kidney injury within 2 days after ECT.CONCLUSION:
We demonstrate that UCT is not inferior to ECT as an initial tool for evaluating APN for screening nephrolithiasis and hydronephrosis without the risk of contrast-induced acute kidney injury (CIAKI). However, patients with an atypical clinical course may still need ECT.
Full text:
Available
Database:
WPRIM (Western Pacific)
Main subject:
Pyelonephritis
/
Mass Screening
/
Diagnosis
/
Emergency Service, Hospital
/
Nephrolithiasis
/
Acute Kidney Injury
/
Hydronephrosis
Type of study:
Diagnostic study
/
Prognostic study
/
Screening study
Limits:
Humans
/
Male
Language:
English
Journal:
Journal of Korean Medical Science
Year:
2018
Document type:
Article