Ultrasound, contrast-enhanced ultrasound and pyelonephritis: A narrative review.

Andrea Boccatonda, Roberta Stupia, Carla Serra
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Abstract

Acute pyelonephritis (APN) is a bacterial infection resulting in kidney inflammation, typically arising as a complication of an ascending urinary tract infection that ascends from the bladder to the kidneys. Clinical diagnosis is generally based on clinical and laboratory findings. Recent guidelines recommend not performing diagnostic imaging unless a complicated APN is suspected or the infection affects high-risk patients such as the elderly, immunocompromised individuals, or diabetics. Contrast-enhanced ultrasound (CEUS) is a valuable tool in both the diagnosis and follow-up of APN. It aids in distinguishing small simple nephritic involvement from abscess complications and monitoring their evolution over time during antibiotic therapy. Given its lack of ionizing radiation and nephrotoxicity, CEUS is a valid diagnostic modality for approaching and monitoring pyelonephritis, improving early identification and characterization of inflammatory lesions. This review aims to summarize the main evidence on the use of ultrasound and CEUS in the diagnosis of APN and its follow-up.

超声波、造影剂增强超声波与肾盂肾炎:叙述性综述。
急性肾盂肾炎(APN)是一种导致肾脏炎症的细菌感染,通常是由膀胱上升到肾脏的上升型尿路感染并发的。临床诊断一般基于临床和实验室检查结果。最新的指南建议,除非怀疑是复杂的 APN 或感染影响到老年人、免疫力低下者或糖尿病患者等高危患者,否则不要进行影像学诊断。对比增强超声(CEUS)是诊断和随访 APN 的重要工具。它有助于区分小的单纯性肾炎受累和脓肿并发症,并在抗生素治疗期间监测其随时间的变化。由于 CEUS 无电离辐射和肾毒性,因此是接近和监测肾盂肾炎的有效诊断方式,可改善炎症病变的早期识别和定性。本综述旨在总结超声和 CEUS 用于诊断 APN 及其随访的主要证据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
3.40
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