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Abdominal Radiology
Published in: Abdominal Radiology 5/2011

01-10-2011 | Original Paper

Clinical significance of periportal tracking as an extrarenal manifestation of acute pyelonephritis

Authors: Robert Vollmann, Gottfried J. Schaffler, Christopher Spreizer, Franz Quehenberger, Helmut Schoellnast

Published in: Abdominal Radiology | Issue 5/2011

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Abstract

Purpose

The purpose of this study was to evaluate whether hepatic periportal tracking (PPT) in patients with acute pyelonephritis correlates with the severity of pyelonephritis.

Material and methods

A database search was conducted of patients with clinically suspected acute pyelonephritis who underwent abdominal computed tomography (CT) between January 2004 and June 2009 for disease evaluation. The final study group consisted of 274 patients (221 women, 53 men) with a mean age of 43 ± 20 years. The abdominal CT studies were retrospectively reviewed by two radiologists by consensus to assess PPT, renal wedge-shaped hypoperfusion areas, and renal abscesses. The laboratory reports obtained on the day of the CT examinations were reviewed for C-reactive protein (CRP), white blood cell count (WBCC), and leukocytes in urine. Presence of PPT was correlated with the presence of renal abscess, extension of renal hypoperfusion areas as well with levels of CRP, leukocytosis, and urine leukocytes using the Fisher’s exact Test and the Wilcoxon Test.

Results

All patients showed renal hypoperfusion areas consistent with the clinical diagnosis of acute pyelonephritis. Twenty-nine patients (11%) showed PPT which was significantly associated with the extension of the wedge-shaped renal hypoperfusion areas (P < 0.001), the presence of a renal abscess (P < 0.01), as well as the level of CRP (P < 0.001) and urine leukocytes (P < 0.01). A renal abscess was observed in 36% of patients with PPT compared with 14% of patients without PPT.

Conclusion

The PPT should be kept in mind as an extrarenal finding in acute pyelonephritis and may indicate a more serious clinical course of the disease.
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Metadata
Title
Clinical significance of periportal tracking as an extrarenal manifestation of acute pyelonephritis
Authors
Robert Vollmann
Gottfried J. Schaffler
Christopher Spreizer
Franz Quehenberger
Helmut Schoellnast
Publication date
01-10-2011
Publisher
Springer-Verlag
Published in
Abdominal Radiology / Issue 5/2011
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-010-9669-6

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