MRI and suspected acute pyelonephritis in children: comparison of diffusion-weighted imaging with gadolinium-enhanced T1-weighted imaging

Abstract

• Diffusion weighted magnetic resonance imaging (DWI) can confirm acute pyelonepritis. • DWI provided comparable results to gadolinium enhanced T1-W MRI in acute pyelonepritis. • Contrast medium injection could be avoided for diagnosing acute pyelonephritis by MRI. • MRI with T2-WI and DWI provide a fast and comprehensive diagnostic tool.

Acute pyelonephritis in transplanted kidneys: can diffusion-weighted magnetic resonance imaging be useful for diagnosis and follow-up?

“…Our results showed that the 46 inflammatory foci had statistically lower ADC values (1.43 ± 0.32 9 10 -3 mm 2 /s) than healthy parenchyma, as measured in the 22 patients with suspected APN (2.06 ± 0.16 9 10 -3 mm 2 /s) and in the 26 patients without suspected APN (1.99 ± 0.14 9 10 -3 mm 2 /s). The ADC ability to identify APN foci in transplanted kidneys, as estimated by the ROC curve, was excellent (95% CI for AUC 0.995-1), determining ADC < 1.9 9 10 -3 mm 2 /s as the region typical of APN foci (PPV = 94% and NPV = 100%) The role of diagnostic imaging in confirming a clinical suspicion of APN and its impact on treatment decisions has been reported by several studies [14][15][16][17][18][19]. In particular it was also emphasized that imaging is indispensable for confirming treatment effectiveness during follow-up [20].…”

“…In particular it was also emphasized that imaging is indispensable for confirming treatment effectiveness during follow-up [20]. DW-MRI with ADC allows functional evaluation of renal lesions and was proved to be reliable for diagnosing APN in native kidneys by several authors [14][15][16][17]. On the contrary, there are still relatively few studies in the literature on the use of DWI in transplanted kidneys, even if the initial results on its use for the assessment of early graft deterioration encountered in nearly 30% of renal allografts seem encouraging [21][22][23][24].…”

“…MR without contrast media, particularly Diffusionweighted magnetic resonance imaging (DW-MRI) and the apparent diffusion coefficient (ADC) value have already been shown capable to distinguish healthy kidney functions from pathologic ones in native kidneys [14][15][16][17]. In particular one study on the diffusion and microcirculation properties of tissues in native kidneys identified three ADC value brackets corresponding, respectively, to healthy parenchyma, acute pyelonephritis (APN) foci, and abscesses, suggesting that ADC maps could be a reasonable alternative to contrast-enhanced MR imaging when contrast media are contraindicated [14].…”

Recurrent urinary tract infections in young children: role of DMSA scintigraphy in detecting vesicoureteric reflux

“…Recently, newer imaging modalities including MRI and contrast-enhanced voiding ultrasonography (ce-VUS) have also been utilized [5,6]. Two distinct imaging approaches, however, have been widely advocated [4,7].…”

Non‐enhanced magnetic resonance imaging versus renal scintigraphy in acute pyelonephritis

“…Intracranial abscesses show up as high‐intensity signals on DWI, with a highly reduced apparent diffusion coefficient (ADC) . A number of studies have described the utility of non‐enhanced MRI for the diagnosis of APN . Kovanlikaya et al .…”