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Diagnostic Ultrasound - Abdomen and Pelvis

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Acute Pyelonephritis<br />

(Left) Longitudinal US shows<br />

there is almost no<br />

corticomedullary<br />

differentiation in this infected<br />

<strong>and</strong> edematous kidney.<br />

Urothelial thickening is<br />

seen in the renal pelvis <strong>and</strong><br />

proximal ureter. The inflamed<br />

perinephric fat is quite<br />

echogenic st. (Right)<br />

Longitudinal US shows this<br />

kidney is diffusely hypoechoic<br />

<strong>and</strong> edematous due to<br />

pyelonephritis.<br />

Diagnoses: Urinary Tract<br />

(Left) Longitudinal US shows<br />

this patient with acute<br />

pyelonephritis has an<br />

enlarged, hypoechoic kidney<br />

with decreased<br />

corticomedullary<br />

differentiation. The renal sinus<br />

is flattened ſt due to diffuse<br />

renal edema. (Right)<br />

Longitudinal color Doppler US<br />

shows there is little peripheral<br />

Doppler flow st in the same<br />

patient with an edematous<br />

kidney <strong>and</strong> acute<br />

pyelonephritis.<br />

(Left) Axial CECT shows a<br />

classic diffuse "striated<br />

nephrogram" in a patient with<br />

acute pyelonephritis. Note the<br />

alternating b<strong>and</strong>s of hypo- <br />

<strong>and</strong> hyperenhancing ſt<br />

parenchyma. (Right) Focal,<br />

wedge-shaped enhancement<br />

defect in the right kidney is<br />

accompanied by subtle<br />

perinephric str<strong>and</strong>ing st <strong>and</strong><br />

thickening of posterior renal<br />

fascia in this patient with<br />

acute pyelonephritis. These<br />

findings help to distinguish<br />

acute pyelonephritis from<br />

renal infarcts.<br />

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