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Acute pyelonephritis: comparison of diagnosis with computed tomography and contrast‐enhanced ultrasonography
Author(s) -
Mitterberger Michael,
Pinggera Germar M.,
Colleselli Daniela,
Bartsch Georg,
Strasser Hannes,
Steppan Ilona,
Pallwein Leo,
Friedrich Aigner,
Gradl Johann,
Frauscher Ferdinand
Publication year - 2008
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2007.07280.x
Subject(s) - medicine , radiology , nuclear medicine , multislice , contrast (vision) , computed tomography , iodinated contrast , artificial intelligence , computer science
OBJECTIVE To assess the value of contrast‐enhanced ultrasonography (US) with the contrast pulse‐sequence (CPS) technique for detecting renal parenchymal changes in acute pyelonephritis (APN), compared with contrast‐enhanced computed tomography (CT) as the reference standard. PATIENTS AND METHODS We examined 100 patients (82 women, 18 men; mean age 30.2 years, range 18–67); children (those aged <18 years) were excluded from the study. All patients had clinical symptoms suggestive of APN. For the US a Sequoia 512 (Acuson, Mountain View, CA, USA) unit including Cadence TM CPS technology, with a 6C2 probe, was used. A bolus of a 2.4‐mL US contrast agent SonoVue (Bracco, Milan, Italy) was injected. For CT a multislice 16‐row unit was used (Sensation 16, Siemens, Erlangen, Germany), at a table speed of 2.5 mm/s and a slice thickness of 3 mm; 100 mL of intravenous iodinated contrast agent (flow 3 mL/s) was injected. RESULTS On contrast CT, 84 patients (84%) had renal parenchymal changes suggestive of APN; on contrast US, 82 of the 84 (98%) showed renal parenchymal changes, and APN was correctly diagnosed. Seventy‐six patients (90%) had unilateral and eight (10%) had bilateral APN, and in two (2%) with APN the diagnosis could not be confirmed by US/CPS (false‐negative). No false‐positive findings were detected on US/CPS, which had a sensitivity of 98%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 89%. CONCLUSION CPS/US is accurate for detecting parenchymal changes in APN; it is very sensitive and specific, and allows small renal parenchymal changes to be detected with no radiation exposure.