Abdominal Imaging

, Volume 18, Issue 1, pp 82–87 | Cite as

Computed tomography of pyonephrosis

  • Patrick J. Fultz
  • William R. Hampton
  • Saara M. S. Totterman
Genitourinary Radiology


Computed tomographic (CT) findings of 17 pyonephrotic and 20 uninfected hydronephrotic kidneys were reviewed. Parameters evaluated included: renal pelvic wall thickness (none; grade 1, ≤2 mm; grade 2, 3–5 mm; and grade 3, >5 mm), renal pelvic contents, parenchymal, and perirenal findings. All patients underwent subsequent percutaneous nephrostomy within 1 week of CT. Common CT findings suggesting pyonephrosis include increased pelvic wall thickness and more severe perirenal fat changes than are seen in uninfected hydronephrosis. However, for any one patient, these findings are often not diagnostic. The presence of clinical signs of infection with hydronephrosis on CT is a more sensitive indicator of pyonephrosis than most CT findings.

Key words

Pyonephrosis, CT diagnosis Kidney, infection Hydronephrosis, CT 


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  1. 1.
    Kenney PJ, Breatnach ES, Stanley RJ. Pyonephrosis. In: Pollack HM, ed. Clinical urography, 1st ed. Philadelphia: Saunders, 1990;843–849Google Scholar
  2. 2.
    Yoder IC, Pfister RC, Lindfors KK, Newhouse JH. Pyonephrosis: imaging and intervention. AJR 1983;141:735–740Google Scholar
  3. 3.
    Morehouse HT, Weiner SN, Hoffman JC. Imaging in inflammatory disease of the kidney. AJR 1984;143:135–141Google Scholar
  4. 4.
    Soulen MC, Fishman EK, Goldman SM, Gatewood OMB. Bacterial renal infection: role of CT. Radiology 1989;171:703–707Google Scholar
  5. 5.
    Nicolet V, Carignan L, Dubuc G, Hébert G, Bourdon F, Paquin F. Thickening of the renal collecting system: a nonspecific findings at US. Radiology 1988;168:411–413Google Scholar
  6. 6.
    Coleman BG, Arger PH, Mulhern CB, Pollack HM, Banner MP. Pyonephrosis: sonography in the diagnosis and management. AJR 1981;137:939–943Google Scholar
  7. 7.
    Subramanyam BR, Raghavendra BN, Bosniak MA, Lefleur RS, Rosen RJ, Horii SC. Sonography of pyonephrosis: a prospective study. AJR 1983;140:991–993Google Scholar
  8. 8.
    Jeffrey RB, Laing FC, Wing VW, Hoddick W. Sensitivity of sonography in pyonephrosis: a re-evaluation. AJR 1985;144:71–73Google Scholar
  9. 9.
    Babcock DS. Sonography of wall thickening of the renal collecting system a nonspecific finding. J Ultrasound Med 1987;6:29–32Google Scholar
  10. 10.
    Kenney PJ. Imaging of chronic renal infections. AJR 1990; 155:485–494Google Scholar
  11. 11.
    Barbaric ZL. Pelvicalyceal wall opacification-a new radiological sign. Radiology 1977;123:587–589Google Scholar
  12. 12.
    Older RA, Cleeve DM, McLelland R. The nonspecificity of some radiological signs in excretory urography. Radiology 1978;127:553–554Google Scholar
  13. 13.
    Gold RP, McClennan BL, Rottenberg RR. CT appearance of acute inflammatory disease of the renal interstitium. AJR 1983;141:343–349Google Scholar
  14. 14.
    Parienty RA, Pradel J, Picard J-D, Ducellier R, Lubrano J-M, Smolarski N. Visibility and thickening of the renal fascia on computed tomograms. Radiology 1981;139:119–124Google Scholar
  15. 15.
    Kunin M. Bridging septa of the perinephric space: anatomic, pathologic and diagnostic considerations. Radiology 1986;158:361–365Google Scholar
  16. 16.
    Soulen MC, Fishman EK, Goldman SM. Sequelae of acute renal infections: CT evaluation. Radiology 1989;173:423–426Google Scholar

Copyright information

© Springer-Verlag New York Inc. 1993

Authors and Affiliations

  • Patrick J. Fultz
    • 1
  • William R. Hampton
    • 1
  • Saara M. S. Totterman
    • 1
  1. 1.Department of Diagnostic RadiologyUniversity of Rochester Medical CenterRochesterUSA

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