Diffusion-weighted magnetic resonance imaging: new perspectives in the diagnostic pathway of non-complicated acute pyelonephritis.
Objectives: The diagnosis of acute pyelonephritis (APN) requires demonstration of parenchymal involvement. When no predisposing conditions are found, non-complicated APN is suspected and CT or MRI should be performed. Diffusion-weighted (DW) MRI might be useful, quicker and cheaper than the standard...
| Publicado en: | European Radiology Vol. 23; no. 11; pp. 3077 - 3087 |
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| Autores principales: | , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Nov2013
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104103261&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104103261 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Nov2013 vid: 23 iid: 11 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104103261 NLM23749224 2012337681 10.1007/s00330-013-2906-y NLM23749224 104103261 ppf: 3077 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Diffusion-weighted magnetic resonance imaging: new perspectives in the diagnostic pathway of non-complicated acute pyelonephritis. aug: au: De Pascale, Agostino Piccoli, Giorgina Barbara Priola, Sandro Massimo Rognone, Daniela Consiglio, Valentina Garetto, Irene Rizzo, Laura Veltri, Andrea affil: Department of Diagnostic Imaging, San Luigi Gonzaga Hospital, University of Torino, Orbassano, Torino, Italy. sug: subj: Magnetic Resonance Imaging Methods Kidney Pathology Pyelonephritis Diagnosis Acute Disease Adolescence Adult Aged Aged, 80 and Over Female Prospective Studies Contrast Media Diagnostic Use Human Male Middle Age Reproducibility of Results Retrospective Design Young Adult Adolescent: 13-18 years Adult: 19-44 years Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female Male ab: Objectives: The diagnosis of acute pyelonephritis (APN) requires demonstration of parenchymal involvement. When no predisposing conditions are found, non-complicated APN is suspected and CT or MRI should be performed. Diffusion-weighted (DW) MRI might be useful, quicker and cheaper than the standard gadolinium-enhanced (GE) MRI. The aim of this study is to compare DW-MRI with GE-MRI to test its diagnostic accuracy in APN.Methods: Of 318 consecutive patients hospitalised for APN, 279 underwent MRI. Four hundred and fourteen MR studies (first test and follow-up examinations) were gathered and data were processed using Diffusion Analysis software. DW-MRI has been compared with GE-MRI for evaluating diagnostic agreement.Results: Two hundred and forty-four patients were diagnosed as having APN; 35 were negative. One hundred and sixty-three APN cases were considered non-complicated and selected for the study. Among the 414 MR examinations, comparing DW-MRI with GE-MRI, positive correlation was found in 258 cases, negative in 133. There were 14 false-negatives and 9 false-positives. DW-MRI achieved sensitivity 95.2 %, specificity 94.9 %, positive predictive value 96.9 %, negative predictive value 92.3 % and accuracy 94.6 %.Conclusions: DW-MRI is reliable for diagnosing non-complicated APN. The high diagnostic agreement between DW-MRI and GE-MRI offers new perspectives in diagnostic management, enabling diagnosis of non-complicated APN without using ionising radiation or contrast media.Key Points: • The diagnosis of acute pyelonephritis (APN) requires demonstration of renal involvement. • Hitherto magnetic resonance imaging required gadolinium enhancement (GE-MRI) to establish this diagnosis. • But diagnostic agreement between diffusion-weighted and GE-MRI offers new diagnostic opportunities. • Quantification of ADC values can help diagnose and monitor APN. • DW-MRI avoids ionising radiation and paramagnetic contrast medium administration. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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