[Diagnosis of acute pyelonephritis. Contribution of modern imaging]

Abstract

Intravenous pyelography (IVP) is a common procedure in acute pyelonephritis (APN). In fact, IVP is unable to show the extent of the renal tissue lesions. It only determines the patency of the urinary tract, thus ruling out secondary (i.e. surgical) APN. Modern imaging comprises ultrasonography, CT scan with injection of contrast medium, and cortical scintigraphy using GH or DMSA technetium. These investigations, used separately or in combination, are of considerable interest in the diagnosis, treatment and follow up of acute infections of the upper urinary tract. Such infections entail more severe sequelae (cortical scars) than previously thought.