Acute pyelonephritis with abscess - Color Ultrasound


Title: Color Ultrasound - Acute pyelonephritis with abscess
Diagnosis: Acute pyelonephritis with abscess
Author: Dr.ROSSET Antoine
Comment: Dr. KHAN Haleem
Hospital: HUG
Department: Radiologie
State: Terminée
Date: 21.03.2003
: 4242
Chapter: Urology

Clinical Presentation: Acute flank pain with fever anddysuria.
Comment: Acute pyelonephritis can be demonstrated on sonographyas renal
enlargement, compression of the renal sinus, abnormalechostructure, loss of
corticomedullary differentiation, or as apoorly marginated mass. Color Doppler or Energy
Doppler scan showzones of hypovascularity corresponding to regions of reactiveischemia
to tubulointerstitial inflammation of the kidneys.Sonography overall is not as sensitive as
CT in determining thepresence and extent of abcess and perinephricinflammation.
Description: The right kidney is enlarged and in the upper pole aloss of
corticomedullary differentiation is noted. Moreover ahypoechoic mass is visible posteriorly
with compression of thecentral renal sinus. The Color Doppler and Energy Doppler
studyshows hypovascularity in the upper renal pole. The CT correlatesthese findings,
revealing a coarse striated nephrogram with theareas of diminished nephrogram
representing inflammatory changes inthe interstitium.

Order: 101
Dislocation: 0
Polytrauma: 0
Open: 0
Pathologic: 0
Operation: 00.00.00
Graft: 0

Question: What is the diagnosis?
Answer A: Acute pyelonephritis with abscess
Answer B: Wilms Tumor
Answer C: Neuroblastoma
Answer D: Trauma

Question: What is the effect on doppler?
Answer A: Doppler is reduced
Answer B: Doppler is unchanged
Answer C: Doppler is increased
Answer D: Doppler? What is it??
Comment: Doppler is reduced due to theinflammation.

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