Delayed CT findings in acute renal infection

• Published in: Clinical radiology 1995-06, Vol.50 (6), p.364-370
• Main Authors: Dalla-Palma, L., Pozzi-Mucelli, F., Pozzi-Mucelli, R.S.
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Aged; Biological and medical sciences; Candidiasis - diagnostic imaging; Escherichia coli Infections - diagnostic imaging; Female; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Proteus Infections - diagnostic imaging; Pyelonephritis - diagnostic imaging; Pyelonephritis - microbiology; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Staphylococcal Infections - diagnostic imaging; Time Factors; Tomography, X-Ray Computed; Urinary system
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/S0009-9260(05)83132-0

The computed tomography (CT) findings in twelve patients with acute renal infection examined immediately and 3 h after i.v. contrast medium are reported. Three patients also had delayed scans at 6 h. Three main features were observed on the delayed scans: 1 a delayed nephrogram with streaky, wedge shaped or round high density areas. The areas of high density were at the same sites of the inhomogeneous areas of reduced density on the early scans; 2 focal contrast medium staining or a rim of increased density around abscesses; 3 focal areas of increased density at sites distant from the low density areas seen on the early scans. It is postulated that the delayed areas of increased density replace early areas of reduced density caused by ischemia due to vasospasm and/or compressing oedema of the vascular bed or by tubular obstruction. Delayed CT appears to be useful because it improves diagnostic confidence and gives a more exact evaluation of the extent of infection.