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Pediatric Radiology

, Volume 23, Issue 4, pp 281–285 | Cite as

Rational use of CT in acute pyelonephritis: Findings and relationships with reflux

  • J. N. Dacher
  • B. Boillot
  • D. Eurin
  • C. Marguet
  • P. Mitrofanoff
  • P. Le Dosseur
Article

Abstract

Enhanced renal CT scanners were performed in 38 children (82% girls) to rule out acute pyelonephritis. Patients were divided in 2 groups on the basis of clinical presentation and bacteriology data. In patients of group A (n=16, preliminary study), upper urinary tract infection (UTI) was certain. CT confirmed the diagnosis in all but 3 patients (a 2-year-old child and 2 patients with UTI developed on prior obstruction). In subsequently studied patients of group B (n=22), clinical findings or bacteriology data were negative or questionable. CT made the diagnosis of acute pyelonephritis in 11 patients. As well as DMSA scintigraphy, CT scanner can help to diagnose or to rule out upper UTIs in difficult cases. In all boys of both groups, ipsilateral vesico-ureteric reflux (VUR) was found by subsequent voiding cystourethrography (VCUG) on the side of pyelonephritis. In girls, this correlation was shown in only 7 of the 25 kidneys with pyelonephritis. This result supports the hypothesis of a gender-dependent contamination. We believe that absence of radiologic reflux cannot exclude the possibility of bacterial crossings of ureteric meatus capable to lead to genuine upper UTIs.

Keywords

Public Health Urinary Tract Tract Infection Urinary Tract Infection Clinical Finding 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • J. N. Dacher
    • 1
  • B. Boillot
    • 2
  • D. Eurin
    • 1
  • C. Marguet
    • 3
  • P. Mitrofanoff
    • 2
  • P. Le Dosseur
    • 1
  1. 1.Department of Pediatric Radiology, Hôpital Charles NicolleUniversity HospitalRouenFrance
  2. 2.Department of Pediatric Surgery, Hôpital Charles NicolleUniversity HospitalRouenFrance
  3. 3.Department of Pediatrics, Hôpital Charles NicolleUniversity HospitalRouenFrance

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