Skip to main content
SpringerLink
Log in

MRI and DW-MRI of Acute Pyelonephritis (APN)

  • Chapter
  • First Online:
Imaging and Intervention in Urinary Tract Infections and Urosepsis

Abstract

An accurate evaluation of acute pyelonephritis (APN) requires imaging of parenchymal involvement. When no predisposing conditions to complicated APN are found at US, noncomplicated APN is suspected, and CT or MRI should be performed. As patients with noncomplicated APN are mostly young women, gadolinium-enhanced (GE) MRI is preferred. Diffusion-weighted (DW) MRI might be quicker and cheaper than standard GE-MRI and is reliable for diagnosing or ruling out noncomplicated APN, due to the high diagnostic agreement with GE-MRI. However, GE-MRI is still mandatory for accurately staging APN within 48 h after diagnosis. DWI with ADC evaluation might be also useful in following therapeutic management of APN, without using ionizing radiation or contrast media.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Craig WD, Brent JW, Travis MD (2008) From the archives of the AFIP, pyelonephritis: radiologic-pathologic review. Radiographics 28:255–276

    Article  PubMed  Google Scholar 

  2. Schappert SM, Rechtsteiner EA (2011) Ambulatory medical care utilization estimates for 2007. Vital Health Stat 13(169):1–38

    Google Scholar 

  3. Hooton TM, Stamm WE (1997) Diagnosis and treatment of uncomplicated urinary tract infection. Infect Dis Clin N Am 11:551–581

    Article  CAS  Google Scholar 

  4. Ramakrishnan K, Schedi DC (2005) Diagnosis and management of acute pyelonephritis in adults. Am Fam Physician 71:933–942

    PubMed  Google Scholar 

  5. Georgi A, Reddy YNV, Gautam G (2012) Diagnosis of acute pyelonephritis with recent trends in management. Nephrol Dial Transplant 27:3391–3394

    Article  Google Scholar 

  6. Ramzan MM, Sandstrom CK (2016) Core curriculum illustration: acute pyelonephritis. Emerg Radiol:1–3. https://doi.org/10.1007/s10140-016-1474-2

  7. Medical Research Council Bacteriuria Committee (1979) Recommended terminology of urinary tract infection: a report by the members of Medical Research Council Bacteriuria committee. Br Med J 2:717–719

    Article  Google Scholar 

  8. Talner LB, Davidson AJ, Lebowitz RL, Dalla Palma L, Goldman SM (1994) Acute pyelonephritis: can we agree on terminology? Radiology 192:297–305

    Article  CAS  PubMed  Google Scholar 

  9. Dyer RB (1997) CT of renal inflammatory disease. Invited commentary. Radiographics 17:867–868

    Google Scholar 

  10. De Pascale A, Piccoli GB, Priola SM et al (2013) Diffusion-weighted magnetic resonance imaging: new perspectives in the diagnostic pathway of non-complicated acute pyelonephritis. Eur Radiol 23(11):3077–3086. https://doi.org/10.1007/s00330-013-2906-y

    Article  PubMed  Google Scholar 

  11. Soulen MC, Fishman EK, Goldman SM, Gatewood OM (1989) Sequelae of acute renal infection: CT evaluation. Radiology 173:423–426

    Article  CAS  PubMed  Google Scholar 

  12. Webb JAW (1987) The role of imaging in adult acute urinary tract infection. Eur Radiol 7:837–843

    Article  Google Scholar 

  13. Parenti GC, Passari A (2001) Pielonefrite acuta: ruolo della diagnostica per immagini. Radiol Med 101:251–254

    CAS  PubMed  Google Scholar 

  14. Majd M, Nussbaum Blask AR, Markle BM et al (2001) Acute pyelonephritis: comparison of diagnosis with 99mTc-DMSA, SPECT, spiral CT, MR imaging, and power Doppler US in an experimental pig model. Radiology 218:101–108. Diffusion-weighted magnetic resonance imaging: new perspectives in the diagnostic pathway of non-complicated acute pyelonephritis

    Article  CAS  PubMed  Google Scholar 

  15. Piccoli GB, Consiglio V, Deagostini MC et al (2011) The clinical and imaging presentation of acute “non complicated” pyelonephritis, a new profile for an ancient disease. BMC Nephrol 12:68–78

    Article  PubMed  PubMed Central  Google Scholar 

  16. Martina MC, Campanino PP, Caraffo F et al (2010) Dynamic magnetic resonance imaging in acute pyelonephritis. Radiol Med 115:287–300

    Article  CAS  PubMed  Google Scholar 

  17. Nikken JJ, Krestin GP (2007) MRI of the kidney: state of the art. Eur Radiol 17:2780–2793

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Hagmann P, Jonasson L, Maeder P, Thiran JP, Wedeen VJ, Meuli R (2006) Understanding diffusion MR imaging technique. Radiographics 26:S205–S223

    Article  PubMed  Google Scholar 

  19. Kawashima A, Sandler CM, Goldman SM (2000) Imaging in acute renal infection. BJU Int 86:70–79

    Article  PubMed  Google Scholar 

  20. Johansen TE (2004) The role of imaging in urinary tract infections. World J Urol 22:392–398

    Article  PubMed  Google Scholar 

  21. Muller MF, Prasad PV, Bimmler D, Kaiser A, Edelman RR (1994) Functional imaging of the kidney by means of measurement of the apparent diffusion coefficient. Radiology 193:711–715

    Article  CAS  PubMed  Google Scholar 

  22. Chow LC, Bammer R, Moseley ME, Sommer FG (2003) Single breath-hold diffusion-weighted imaging of the abdomen. J Magn Reson Imaging 18:377–382

    Article  PubMed  Google Scholar 

  23. Thoeny HC, De Keyzer F, Oyen RH, Peeters RR (2005) Diffusionweighted MR imaging of kidneys in healthy volunteers and patients with parenchymal diseases: initial experience. Radiology 235:911–917

    Article  PubMed  Google Scholar 

  24. Xu Y, Wang X, Jiang X (2007) Relationship between the renal apparent diffusion coefficient and glomerular filtration rate: preliminary experience. J Magn Reson Imaging 26:678–681

    Article  PubMed  Google Scholar 

  25. Carbone SF, Gaggioli E, Ricci V, Mazzei F, Mazzei MA, Volterrani L (2007) Diffusion-weighted magnetic resonance imaging in the evaluation of renal function: a preliminary study. Radiol Med 112:1201–1210

    Article  CAS  PubMed  Google Scholar 

  26. Fanning NF, Laffan EE, Shroff MM (2006) Serial diffusion-weighted MRI correlates with clinical course and treatment response in children with intracranial pus collections. Pediatr Radiol 36:26–37

    Article  PubMed  Google Scholar 

  27. Aoyagi J, Odaka J, Kuroiwa Y, Nakashima N, Ito T, Saito T, Kanai T, Yamagata T, Momoi MY (2014) Utility of non-enhanced magnetic resonance imaging to detect acute pyelonephritis. Pediatr Int 56(3):e4–e6. https://doi.org/10.1111/ped.12312

    Article  CAS  PubMed  Google Scholar 

  28. Kuniyoshi Y, Kamura A, Yasuda A, Tashiro M (2011) Acute pyelonephritis diagnosed by diffusion-weighted whole body imaging with background signal suppression: three case reports. J Jpn Pediatr Soc 115:1919–1925

    Google Scholar 

  29. Vivier P-H et al (2014) MRI and suspected acute pyelonephritis in children: comparison of diffusion-weighted imaging with gadolinium-enhanced T1-weighted imaging. Eur Radiol 24:19–25

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Radiology Department, “San Luigi Gonzaga” University Hospital, Regione Gonzole, 10, Orbassano, TO, 10043, Italy

    Andrea Veltri, Agostino De Pascale & Dario Gned

Authors
  1. Andrea Veltri
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Agostino De Pascale
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dario Gned
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrea Veltri .

Editor information

Editors and Affiliations

  1. Department of Radiology, Luigi Sacco Hospital, Milan, Italy

    Massimo Tonolini

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Veltri, A., De Pascale, A., Gned, D. (2018). MRI and DW-MRI of Acute Pyelonephritis (APN). In: Tonolini, M. (eds) Imaging and Intervention in Urinary Tract Infections and Urosepsis. Springer, Cham. https://doi.org/10.1007/978-3-319-68276-1_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-68276-1_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-68275-4

  • Online ISBN: 978-3-319-68276-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation