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Congress: ECR25
Poster Number: C-25177
Type: Poster: EPOS Radiologist (educational)
DOI: 10.26044/ecr2025/C-25177
Authorblock: A. Evangelisti, P. Comite, G. Antogiovanni, A. Boldrini, S. Ammar, G. B. Scalera, M. Scialpi; Perugia/IT
Disclosures:
Arianna Evangelisti: Nothing to disclose
Paola Comite: Nothing to disclose
Giuseppe Antogiovanni: Nothing to disclose
Alessia Boldrini: Nothing to disclose
Saber Ammar: Nothing to disclose
Giovanni Battista Scalera: Nothing to disclose
Michele Scialpi: Nothing to disclose
Keywords: Kidney, MR, Imaging sequences, Infection
Learning objectives Acute pyelonephritis (APN) is a bacterial infection of the renal parenchyma and urinary tract. The diagnosis of urinary tract infection is usually made based on clinical presentations, such as fever and pain in the loin region, and confirmation is achieved by conducting a urine analysis with culture.Accurate and early diagnosis, along with appropriate clinical management, are crucial to prevent severe complications, including sepsis, shock, and even fatal outcomes. In the majority of patients, uncomplicated APN is diagnosed clinically and responds...
Read more Background We retrospectively analyzed the bpMRI scans of 31 patients (26 females and 5 males, aged 20–68 years, with a mean age of 41 years), including 5 patients with transplanted kidneys, between September 2020 and October 2024. All of the patients had clinical and laboratory data indicative of nephritis.Image acquisition MRI examinations were performed on a 3T MRI (Achieva, Philips Medical Systems), with a 16-channel and a torso-phased array coil. All initial and follow-up protocols included axial, sagittal, and/or coronal Turbo...
Read more Findings and procedure details At the initial bpMRI, focal nephritic areas in all patients appeared striated, band-like, or triangular in morphology and were inhomogeneous, moderately-markedly hypointense or homogeneously markedly hypointense on the ADC map. Focal nephritic areas were unilateral in 19 patients of whom 17 with multiple unilateral lesions. Bilateral and multiple nephritic areas were observed in 12 patients. The mean ADC value of all lesions was lower than the grayscale mean ADC value, with a percentage difference ranging from 29% to 53% (mean...
Read more Conclusion Our preliminary study demonstrated that DWI/ADC, as part of bpMRI, is highly effective in diagnosing acute nephritis by analyzing ADC maps of the lesions. Additionally, the quantitative analysis of ADC maps is useful for monitoring disease progression and assessing treatment response over time.However, our study has several limitations. First, the retrospective nature of the study, which included a selected  group of patients, may have introduced selection bias. Second, the small sample size from a single center limits the generalizability of...
Read more References De Perrot T, Sadjo Zoua C, Glessgen CG, Botsikas D, Berchtold L, Salomir R, De Seigneux S, Thoeny HC, Vallée JP. Diffusion-Weighted MRI in the Genitourinary System. J Clin Med. 2022 Mar 30;11(7):1921. Expert Panel on Urological Imaging; Smith AD, Nikolaidis P, Khatri G, Chong ST, De Leon AD, Ganeshan D, Gore JL, Gupta RT, Kwun R, Lyshchik A, Nicola R, Purysko AS, Savage SJ, Taffel MT, Yoo DC, Delaney EW, Lockhart ME. ACR Appropriateness Criteria® Acute Pyelonephritis: 2022 Update. J...
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