Renal inflammatory disease: The current role of CT

Akira Kawashima, Carl M. Sandler, Randy D. Ernst, Stanford M. Goldman, Bharat Raval, Elliot K. Fishman

Research output: Contribution to journalReview article

31 Scopus citations

Abstract

Computed tomography (CT) plays a significant role in establishing the diagnosis in clinically equivocal cases of renal infection, determining the extent of the disease process, and assessing its complications. Gas, calculi, renal parenchymal calcifications, hemorrhage, and masses can be revealed with unenhanced CT. A subsequent study with contrast enhancement is crucial for the complete evaluation of patients with renal infection in order to demonstrate the areas of altered nephrogram that occur as a result of the inflammatory process and to identify complications. In this article we review a spectrum of renal inflammatory disease, with illustrations of the CT findings in representative cases. We also review the role and potential pitfalls of fast scanning techniques that can image a particular phase of the nephrogram in a renal infection. In acute pyelonephritis, enhanced CT scans obtained during the cortical nephrographic phase typically demonstrate solitary or multifocal hypodense areas with obliteration of the corticomedullary differentiation. Delayed images obtained during the excretory phase are frequently more helpful in defining the extent of the disease process, identifying the complications such as renal abscess, and confirming the presence of urinary obstruction than are early images.

Original languageEnglish (US)
Pages (from-to)369-415
Number of pages47
JournalCritical Reviews in Diagnostic Imaging
Volume38
Issue number5
StatePublished - Dec 12 1997

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Keywords

  • Fungi
  • Kidney disease
  • Kidney, CT
  • Kidney, infection
  • Nephritis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Kawashima, A., Sandler, C. M., Ernst, R. D., Goldman, S. M., Raval, B., & Fishman, E. K. (1997). Renal inflammatory disease: The current role of CT. Critical Reviews in Diagnostic Imaging, 38(5), 369-415.