Presentation
Right flank pain for the last four days. She had a fever of 38 degrees and anorexia.
Patient Data
Age: 20 years
Gender: Female
CT technique:
Single-phase quad-bolus IV contrast-enhanced polychromatic spectral CT.
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There are two large wedge-shaped areas of hypoperfusion involving the right kidney, in conjunction with infective symptoms favored to represent changes of acute pyelonephritis.
From the case:
Acute pyelonephritis (dual energy CT)
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- there are two large wedge-shaped hypodense areas involving the right kidney, in conjunction with infective symptoms favored to represent changes of acute pyelonephritis
- normal liver, adrenals, spleen, pancreas, small bowel, large bowel, omentum, and mesentery
- the gallbladder shows no stones, CBD is of normal caliber, and portal vein is also of normal caliber
- no free fluid, free gas, or hernia
- no enlarged lymph nodes
- no acute vasculopathy
Case Discussion
Dual-energy CT can improve the diagnosis of inflamed kidney foci in acute pyelonephritis in comparison to conventional imaging 1. Dual-energy CT allows for the identification of pathologic foci of inflamed kidney parenchyma, which is beneficial in the evaluation of acute pyelonephritis 1.
Case also courtesy of Dr. Zane Sherif