TITLE

Diffusion–Weighted Imaging and Apparent Diffusion Coefficient Values Versus Contrast–Enhanced MR Imaging in the Identification and Characterisation of Acute Pyelonephritis

AUTHOR(S)
Faletti, Riccardo; Cassinis, Maria Carla; Fonio, Paolo; Grasso, Angela; Battisti, Giacomo; Bergamasco, Laura; Gandini, Giovanni
PUB. DATE
December 2013
SOURCE
European Radiology;Dec2013, Vol. 23 Issue 12, p3501
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objective: To compare contrast-enhanced (CEMR) and diffusion-weighted (DWI) magnetic resonance imaging in diagnosing acute pyelonephritis (APN) and to assess ADC measurement reliability in differentiating among normal renal parenchyma, APN and abscesses. Methods: Eighty-eight patients (80 women, mean age 36.5 years) with clinical suspicion of APN were retrospectively reviewed. An experienced observer quantified lesions with a score ranging from 0 to 3. DWI and CEMR were compared on the basis of the assigned score, total examination number (88) and on presence (36)/absence (52) of abscesses. ADC values, calculated at the healthy parenchyma, APN and abscessed were compared to each other. Results: Agreement between CEMR and DWI was 94.3 % (83/88 patients; P < 0.05). In the APN group, DWI was awarded the highest visibility score compared to CEMR ( P = 0.05), while in the abscess group CEMR had the highest score ( P = 0.04). The difference between ADC values of the APN-healthy parenchyma and abscess-APN groups was significant ( P < 0.05). The area under the ROC curve of ADC values of the APN-healthy and abscess-APN groups were found to be 0.94 (95 % CI; cutoff value = 2) and 0.78 (95 % CI; cutoff value = 1.2) respectively. Conclusions: Diffusion-weighted imaging appears reliable in the diagnosis and follow-up of acute pyelonephritis and could provide a reasonable alternative to contrast-enhanced magnetic resonance imaging. Key Points: • Acute pyelonephritis (APN) is an inflammatory process that preferentially affects young women• Contrast-enhanced MRI is the reference investigation for the diagnosis and follow-up of APN• Diffusion-weighted imaging can help differentiate between APN and abscesses• This is especially useful when administration of contrast agent is contraindicated.
ACCESSION #
91929902

 

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